The VAD Act (2021) includes provision for a review after five years. This means that the government will arrange for a review in 2027. The Terms of Reference for the review will be determined by the Minister of Health.
The South Australian VAD Act is modelled on the Victorian VAD Act, with the addition of institutional conscientious objection in the South Australian legislation.
Following the review of the Victorian VAD Act, the Victorian Parliament recently passed 13 amendments to their legislation. These changes will not come into operation until April 2027. Key changes were
- Removing the ‘gag clause’ so that registered health practitioners are allowed to raise VAD with their patients during discussion about end of life options
- Requiring registered health practitioners who conscientiously object to provide minimum information
- Extending the prognosis requirement (life expectancy limit for eligibility) from six months to 12 months
- For people with neurodegenerative diseases (like motor neurone disease), they’ll no longer need a third prognosis if their expected lifespan is between six and 12 months
- Introducing a new administering practitioner role to expand the workforce able to support VAD.
VADSA will be advocating for similar changes.
In addition to the amendments passed in Victoria, VADSA will advocate for
Prognosis: removal of the time limited prognosis of six or 12 months (similar to the ACT), greater participation of nurse practitioners (similar to WA) and explore whether medical practitioners should continue to require special VAD training (no other jurisdiction in the world mandates VAD training for health practitioners).
Institutional Conscientious Objection to VAD by Private Hospitals: incorporation of similar provisions to those in the Queensland and ACT VAD Acts which allow private hospitals to retain a conscientious objection to providing VAD services, but must allow VAD services to be provided by other health practitioners and support staff.
Disability Aware VAD: Many provisions in the VAD Act unintentionally discriminate against people with a disability. VADSA will propose the development of a disability aware voluntary assisted dying process.
The process would include
1. Guiding Principle in all VAD documentation and training modules requiring equal access to VAD for someone living with a disability
2. Provision for a Disability Interpreter nominated by the person with the disability
3. Disability Care Navigators to support a person with a disability navigate the VAD request process.
4. Provision for the consulting medical assessment for a person with a disability to be conducted through telehealth
5. VAD Disability witnesses to be available if required for a person with a disability.
Incorporating these five components into the operating guidelines for VAD would assist in ensuring more equitable access to a compassionate end of life choice for a person with a disability as well as a terminal illness.