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Scope of practice for medical practitioners and healthcare workers

Learn more about the practitioner eligibility requirements and submit your application to become an authorised voluntary assisted dying practitioner.

The table below provides an overview of the scope of practice for healthcare workers in voluntary assisted dying.

Table 1. Overview of the scope of practice for various healthcare workers in voluntary assisted dying
*A registered health practitioner is a person (other than a student) who is listed as a health professional with the Australian Health Practitioner Regulatory Agency (Ahpra) under the Health Practitioner Regulation National Law (Queensland).

Medical practitioner

Nurse practitioner

Registered nurse

Other registered health practitioners*

Other healthcare workers

Act as the coordinating practitioner (if eligible, verified, completed training)

Act as the consulting practitioner (if eligible, verified, completed training)

Act as the administering practitioner (if eligible, verified, completed training)

Initiate a conversation about VAD in the course of informing about all end of life options

Provide information about VAD to a person who has requested it

Accept referral to determine whether the person has an eligible diagnosis or prognosis

Accept referral to determine whether the person has decision-making capacity in relation to VAD

Accept referral to determine whether the person is acting voluntarily and without coercion

Continue to provide care to a person and their family, knowing they are accessing VAD

Medical practitioners, nurse practitioners and registered nurses' roles

Only a medical practitioner or nurse practitioner can initiate a conversation about voluntary assisted dying. If any other healthcare worker initiates a conversation about voluntary assisted dying, they could be found in breach of the Act. A healthcare worker can provide general information at the person’s request, which must be a clear and unambiguous question. Learn more about responding to a person asking about voluntary assisted dying.

Medical practitioners

Medical practitioners who meet the eligibility requirements, have completed the mandatory training, and are endorsed as an authorised voluntary assisted dying practitioner can be involved in the process.

This includes being able to perform the roles of coordinating practitioner, consulting practitioner, and administering practitioner.

Medical practitioners can also be involved in assessing an aspect of a person’s eligibility for voluntary assisted dying after receiving a referral from a coordinating or consulting practitioner, if they have appropriate skills and training. They can accept a referral to determine whether the person:

  • has a disease, illness or medical condition that is:
    • advanced, progressive and will cause death
    • expected to cause death within 12 months, and
    • causing suffering that the person considers to be intolerable; and
  • has decision-making capacity for voluntary assisted dying
  • is acting voluntarily and without coercion.
Table 2. Overview of medical practitioner roles specified in the Voluntary Assisted Dying Act 2021.

Role

Functions

Who can act in this role

Coordinating practitioner

  • Coordinates the voluntary assisted dying process
  • Primary voluntary assisted dying contact for the person
  • Conducts eligibility assessment
  • Refers the person to another medical practitioner for a second eligibility assessment
  • Assists the person with making their administration decision
  • Prescribes the voluntary assisted dying substance
  • As a default, acts as administering practitioner (for practitioner administration)

Eligible medical practitioner who has successfully completed mandatory training and has been endorsed as an authorised voluntary assisted dying practitioner

Consulting practitioner

  • Conducts eligibility assessment

Eligible medical practitioner who has successfully completed mandatory training and has been endorsed as an authorised voluntary assisted dying practitioner

Administering practitioner

  • Only involved in practitioner administration (not self-administration)
  • Administers the voluntary assisted dying substance
  • Disposes of any unused or remaining voluntary assisted dying substance

As a default, this will be the coordinating practitioner, but the role can be transferred to another eligible medical practitioner, nurse practitioner, or registered nurse who has successfully completed mandatory training and has been endorsed as an authorised voluntary assisted dying practitioner.

Nurse practitioner and registered nurse roles

Nurse practitioners and registered nurses who meet eligibility requirements, undertake mandatory training, and are endorsed as an authorised voluntary assisted dying practitioner can participate as an administering practitioner, if this role is transferred to them by the coordinating practitioner. This means they can administer the voluntary assisted dying substance to a person who has chosen practitioner administration.

Table 3. Scope of practice for nurse practitioners and registered nurses in voluntary assisted dying.

Nurse Practitioner

Registered Nurse

Can

Cannot

Can

Cannot

  • Act as the administering practitioner if the coordinating practitioner transfers this role to them AND they meet the approved voluntary assisted dying nurse practitioner requirements.
  • Initiate a conversation about voluntary assisted dying if, at the same time, they inform the person about available:
    • Treatment options and likely outcomes; and
    • Palliative care and support options and likely outcomes of this care.
  • Act as a coordinating or consulting practitioner.
  • Act as a coordinating or consulting practitioner.
  • Initiate a conversation about voluntary assisted dying.

Registered nurses and nurse practitioners can be involved in assessing a person’s eligibility for voluntary assisted dying after receiving a referral from a coordinating or consulting practitioner, if they have appropriate skills and training to determine the matter. They can accept a referral to determine whether the person:

  • has a disease, illness or medical condition that is:
    • advanced, progressive and will cause death
    • expected to cause death within 12 months and
    • causing suffering that the person considers to be intolerable; and
  • has decision-making capacity for voluntary assisted dying
  • is acting voluntarily and without coercion.

Roles for healthcare workers

Along with providing care and support to the person, healthcare workers can be involved in assessing a person’s eligibility to access voluntary assisted dying.

Table 4. Who can receive and accept referrals for determination in voluntary assisted dying.

Reason for referral for determination

Who can receive and accept the referral

The coordinating and/or consulting practitioner must refer the matter to another suitably qualified person if they are unable to determine if a person:

Has a disease, illness, or medical condition that:

  • is advanced, progressive and will cause death
  • is expected to cause death withing 12 months
  • is causing suffering that the person considers to be intolerable.

Any registered health practitioner with appropriate skills and training to determine whether a person has an eligible disease or prognosis.

It is recommended that a medical practitioner or nurse practitioner with a relevant scope of practice determines the disease or prognosis.

Has decision-making capacity.

Any registered health practitioner with appropriate skills and training to determine whether a person has an eligible disease or prognosis or decision-making capacity.

For example, a psychologist.

Is acting voluntarily and without coercion.

Any person with appropriate skills and training to determine whether a person is acting voluntarily and without coercion.

For example, a social worker.

Pharmacist roles

Only pharmacists working for the Queensland Voluntary Assisted Dying Pharmacy Service (QVAD-Pharmacy) will be authorised to supply voluntary assisted dying substances.

Paramedics and other first responder roles

In rare occurrences, first responders may be involved in a situation where a person is administering a voluntary assisted dying substance. First responders can provide palliative and comfort care to the person and can also provide support for the family.

However, first responders usually have a duty to administer life-sustaining or life-preserving medical treatment. This is not the case with voluntary assisted dying.

The Act provides protection from civil and criminal liability for registered health practitioners, ambulance officers (and volunteers), and students under the Health Practitioner Regulation National Law (Queensland) who, acting in good faith, don’t administer life-sustaining treatment where:

  • the person doesn’t request it; and
  • they believe on reasonable grounds that the person is dying after administration of the voluntary assisted dying substance (either self-administered or practitioner administered in accordance with the Act).

This means that a first responder who withholds life-sustaining treatment to a person they believe on reasonable grounds is dying after administration of the voluntary assisted dying substance is protected in accordance with the Act. This is on the basis that the patient has not directly requested life-sustaining treatment.

Queensland Voluntary Assisted Dying Support Service (QVAD-Support)

The Queensland Voluntary Assisted Dying Support Service (QVAD-Support) will:

  • provide advice and support to Queenslanders about voluntary assisted dying
  • be staffed by care coordinators.

Care coordinators will be medical, nursing, and allied health professionals.

The service will provide support to anyone involved with voluntary assisted dying in Queensland, including:

  • people who want to access voluntary assisted dying
  • carers and family members of people wanting to access voluntary assisted dying
  • healthcare workers
  • healthcare providers.

QVAD-Support care coordinators will connect individuals with appropriate practitioners, services and referral pathways.

Last updated: 9 June 2022