Legal obligations for all medical practitioners

Medical practitioners can choose not to participate in the voluntary assisted dying process, but all medical practitioners have obligations under the Voluntary Assisted Dying Act 2021 (the Act). These are:

1. Initiating a discussion—providing specific information if the medical practitioner initiates a conversation about voluntary assisted dying with a person.
2. Responding to a first request—following a set process when receiving a first request for access to voluntary assisted dying.
3. Completing a cause of death certificate—following mandatory steps when completing a cause of death certificate for a person who died by accessing voluntary assisted dying.

The Queensland Voluntary Assisted Dying Handbook includes information on the legal protections and offences as outlined in the Voluntary Assisted Dying Act 2021.

Initiating a discussion about voluntary assisted dying

Only medical practitioners and nurse practitioners can initiate a discussion about voluntary assisted dying if, at the same time, they inform the person about available:

• treatment options and likely outcomes
• palliative care treatment and support options and likely outcomes of this care.

If a person raises voluntary assisted dying, all medical practitioners can provide information and answer questions if they feel comfortable and informed to do so.

If a medical practitioner has a conscientious objection and does not wish to provide information, they must provide the person with:

• information about a health practitioner, provider, or service they believe is likely to be able to assist, or
• the Queensland Voluntary Assisted Dying Support Service (QVAD-Support) contact details.

If a person raises voluntary assisted dying

Medical practitioners must follow legislated requirements under the Act if a person requests to start the voluntary assisted dying process (the first request).

If a person asks a medical practitioner for information about voluntary assisted dying, the practitioner should consider their response to best support the person. They should:

• explore the topic with respect and consideration to better understand what support the person may need and their preferences for end-of-life care
• record conversations about voluntary assisted dying in the person’s medical record, including any referrals made.

Learn more about the scope of practice for medical practitioners and healthcare workers.

Choosing not to participate

Medical practitioners can refuse to participate in any part of voluntary assisted dying for any reason, including:

• a conscientious objection to voluntary assisted dying
• not having the appropriate skills or training to be involved in the process
• not being available to assist the person with the process.

The Act includes provisions for medical practitioners who don’t want to participate in the voluntary assisted dying process. However, they must provide the person with information to enable them to access voluntary assisted dying, including:

• information about a health practitioner, provider, or service they believe is likely to be able to assist; or
• the Queensland Voluntary Assisted Dying Support Service (QVAD-Support) contact details.

Responding to a first request

A first request is the first formal step in the voluntary assisted dying process.

A first request must be:

• clear and unambiguous
• made by the person
• made to a medical practitioner.

A first request can be made through any of the following means:

• verbally
• by gestures
• by other means of communication available to the person.

A person must make the first request themselves (directly, through a certified interpreter, or with the support of a relevant healthcare worker such as a speech pathologist or occupational therapist). The first request cannot be made by another person on the person’s behalf. This includes family members, carers, friends and any other substitute decision-maker (for example, someone appointed by an enduring power-of-attorney). A request to access voluntary assisted dying cannot be made via an advance health directive.

A person may use an interpreter to make a first request to access voluntary assisted dying. The QVAD Handbook provides more information on how to work with interpreters.

The person does not have to use the term ‘voluntary assisted dying’, but the request must be clear and unambiguous.

Process for responding to a first request

Accepting or refusing the first request

There is no obligation for a medical practitioner to accept a first request—it is a personal choice. Regardless of whether a first request is accepted or refused, the medical practitioner is required to complete certain steps, which are outlined above in Figure 1.

When deciding whether to accept or refuse a first request, a medical practitioner should consider their:

• willingness to be involved
• eligibility to become an authorised VAD practitioner.

Accepting a first request

A medical practitioner does not need to have completed mandatory training or become authorised by the Chief Medical Officer of Queensland Health to accept a person’s first request.

However, they must have done so before they undertake the first assessment.

Refusing a first request

A medical practitioner must refuse the first request if they are not eligible to act as a coordinating practitioner.

A medical practitioner may refuse the first request if they:

• are unwilling to perform the duties of coordinating practitioner, for example, they do not want to be the coordinating practitioner for the person
• are unable to perform the duties of coordinating practitioner, for example, they cannot commit the time required
• hold a conscientious objection to voluntary assisted dying.

All medical practitioners must take certain steps within specified timeframes after refusing a first request, regardless of their reason for refusal, as summarised above in Figure 1.

Criminal Code Act 1995 (Cth)

The Criminal Code Act 1995 (Cth) prohibits discussing suicide via a carriage service (e.g. phone, telehealth or the internet). While the Queensland Voluntary Assisted Dying Act 2021 states that voluntary assisted dying is not suicide, this cannot change the interpretation of the Commonwealth laws. This means that some discussions between a person and their doctor about the voluntary assisted dying process will need to happen face-to-face. Guidance will be provided for health practitioners.

Read the Guidance for practitioners—Discussions about voluntary assisted dying over carriage service (PDF 1805 kB) for more information.