Just 9% of GPs in the survey rated their understanding of VAD as excellent, while 47% said they had a moderate understanding, 40% said they had limited understanding and 4% said they had no understanding.
Drilling down further, the results show a range of views.
VAD is now legal in all Australian states and territories – with the Northern Territory passing legislation late last month – but the reality is, it is not an option in many circumstances.
To be eligible for VAD in Australia, a patient must be at least 18 and have an advanced, progressive medical condition that will cause death within a specific timeframe (e.g. six or 12 months, with the specifics differing depending on the state) and intolerable suffering related to that condition – and they continue to have decision-making capacity throughout the process including at the time any drugs are administered.
However, Healthed’s poll suggests many GPs would support broader access to VAD in circumstances that are currently precluded. For example, doctors are split 50-50 on whether it should be an option for patients with advanced dementia, and 32% would support it for children with a terminal illness, both of which are prohibited under current regulations, regardless of the state or territory.
“Advanced age is a difficult one. I think people may be pressured to use VAD due to age, although if it is truly their own decision, I could support it. VAD had been very normalised in some European countries and perhaps is overused by the elderly.”
“As with anything, I think I would support some of these on a case-by-case basis: e.g. moderate dementia in a person who had a very clear Advanced Care Directive. With elderly or pain, overall I’d be hesitant, but I have no doubt there would be exceptions.”
“I believe dementia should be eligible for VAD but I feel the challenge is what level of dementia would be consider appropriate for making this decision.”
Others were more resolute. “In my opinion there are no circumstances where VAD should be practised,” one GP said.
On the other end of the spectrum, some said as long as appropriate safeguards were in place, they were supportive.
“Assuming that there are checks and balances in the system to ensure a person is not manipulated/forced into the decision, and that they are competent to make the decision, then I generally support VAD for most situations. It’s patronising and arrogant to think we know what people want for themselves better than they do, and to make someone suffer through a life they no longer want to be a part of is cruel and inhumane,” one GP said.
Most GPs say telehealth shouldn’t be the default
Just 8% of GPs in the August poll said they were generally supportive of assessing VAD suitability via Healthed, although 23% said they would support it in certain situations. Most – 69% – said they were generally unsupportive of telehealth for VAD assessments.
Overall, 73% of respondents were from metro areas, 23% were from regional areas, and 4% were from remote areas. There were no strong trends related to gender, age, metro vs rural or regional or the state or territory where the respondent lived.
There were small differences in views on telehealth between those who said they had limited or no understanding of VAD more broadly and those who said they had moderate or excellent understanding.
Read more:
Patients are asking about VAD, but many GPs feel unprepared to answer – Healthed
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