Yet 40% of GPs said they have limited understanding of VAD, and another 4% said they have no understanding of it at all.
Voluntary assisted dying is now legal for patients with a life-limiting in all six states, plus the ACT, and the Northern Territory parliament voted to legalise it on Thursday, with VAD is expected to be available there in early 2028.
Given the ageing population, rising rates of chronic disease and increasing public awareness, it’s likely that the number of patients asking about VAD will increase too.
The details of the laws vary depending on the state or territory, so it’s important to be familiar with the laws and eligibility criteria where you live – as well as your obligations as a doctor, regardless of your personal views on VAD. Here’s an overview of what GPs need to know.
While the specific laws vary in each state or territory, all patients must meet strict eligibility criteria.
As Sara Townend and Penelope Burns sum up in this article in the Australian Journal of General Practice, to be eligible for VAD in Australia, a patient must:
You can also find information on the differing requirements through Go Gentle and End of Life Directions for Aged Care (ELDAC).
If a patient wants to apply for voluntary assisted dying, they must make a clear “first request” to a VAD practitioner, who will then coordinate their application. If you have not undergone VAD practitioner training, you should refer the patient to one who can start the process.
When a patient asks their GP about VAD, it’s a chance to review their context more broadly, says Dr Sara Townend, Clinical Director of the NSW VAD Support Service.
“A request for information about VAD is also an opportunity to explore the patient’s goals, preferences and understanding of their illness,” she says. “The trigger for them asking may be an increase in symptoms, functional decline, recent discussions with treating specialists, or a desire to plan for their future. It’s an opportunity for advance care planning, medication review, and consideration of additional supports or referrals.”
While loved ones or those with decision making authority can gather information about VAD, the actual request to apply for VAD must come from the patient themselves and cannot be made under any pressure or coercion.
Patients must be assessed by at least two independent medical practitioners and make at least three requests for VAD during the VAD process. The practitioners must be credentialled in the state or territory where they are doing the assessment.
Both medical practitioners will independently check that the person meets all eligibility criteria. An assessment requires a thorough review of the patient’s context. This will usually include reviewing their medical and social history, including discussions with treating teams and GP.
“If the assessing doctor is uncertain about eligibility, all laws require referral to a specialist with relevant expertise. This includes when there is concern about coercion, decision making capacity or about the terminal diagnosis itself,” Dr Townend explains.
It is important to note that mental illness, disability or dementia by themselves do not make a person eligible for VAD, and requests for VAD cannot be included in an advanced care directive. Patients must have the capacity to confirm that they still wish to continue with VAD right up to the end of the process.
According to End of Life Directions for Aged Care, in Victoria, New South Wales, Western Australia, Queensland and South Australia, the patient has to reconfirm their request throughout the process. All states require written confirmation from the patient, and they can withdraw or pause the process, including up to the time of taking the VAD substance.
Starting the process does not mean the patient will die with assistance
Not all patients who start the process for VAD ultimately die with assistance. For example, in New South Wales, around 1100 people accessed VAD from November 2023 up to June 2025 – and 900 people died without proceeding, according to the NSW VAD Board Reports for 2024 and 2025 (the 2026 report has not yet been published).
Some of these people died prior to completion, and others chose not to proceed. It’s common for patients to draw comfort from knowing it’s an option, Dr Townend says.
When it comes to administering the VAD medications, the patient may opt to do it themselves (usually via oral administration) if they are able, or they can request assistance from a practitioner (for example via IV).
“The rules between states vary, with some requiring oral administration unless the patient is not able to, while others allow patient choice (including WA, NSW, Qld),” Dr Townend says.
The medication is dispensed by a specialist VAD pharmacy. There are strict rules in place about management, including disposal.
The time it takes to process someone’s application varies, Dr Townend notes.
“In the NSW VAD Board report, the average time to approval is 8 days and the average time to proceed is 20 days, but this varies with patient preference, practitioner availability, and clinical factors. In my experience an application is usually 2-4 weeks, sometimes longer – early referral is better to allow the patient and their family to take time with decision making,” she says.
In South Australia, the Northern Territory and currently in Victoria, medical practitioners and other registered health professionals are not permitted to initiate discussions about VAD, but they can give information if the patient asks. The legislation in Victoria is changing in April 2027, and from then, medical practitioners will be permitted to raise the topic.
Doctors in NSW, TAS, WA, QLD and the ACT can initiate VAD discussions, but they must inform the person about palliative care and other available treatment options.
VAD is a voluntary scheme, so doctors can conscientiously object or refuse to take part for other reasons, but depending on where you are, there may still be legal obligations you need to comply with if a request is made.
Doctors can refuse to:
Doctors who have not done the mandatory VAD training must decline requests.
Legal obligations differ depending on the state/territory, as described below.
New South Wales
Queensland
Western Australia
Victoria
South Australia
Tasmania
Australian Capital Territory
For more information
Go Gentle Australia
End of Life Directions for Aged Care Voluntary Assisted Dying Toolkit
You can find out more about the VAD requirements in your state or territory below.
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