What support is available to staff regarding new Voluntary Assisted Dying legislation?

Kat Penna is our Program Manager for voluntary assisted dying. With the new legislation coming into effect on 19 June, we spoke to Kat to understand a bit more about her role and the various resources that are available to support staff if patients they're caring for want to talk about VAD.

What has been our approach to making voluntary assisted dying available to eligible patients in our care?

The Austin Health Board and Executive have made the decision to support patients who may wish to access voluntary assisted dying.

A steering committee and working group, led by our Clinical Ethics Lead Dr Danielle Ko, has spent the past 12 months liaising with DHHS, consulting with international experts and reviewing literature related to VAD to understand the experience in other countries where similar legislation has been implemented. A staff survey was also undertaken to understand Austin staff views on voluntary assisted dying and what their concerns were to ensure that we're taking an appropriate and considered approach to this issue.

My position as VAD Program Manager was also created to help implement the legislation and support staff and patients as required. We believe this position is unique to Austin Health.

What information has been available to staff regarding the VAD legislation?

We've been having conversations over the past 12 months with clinical and non-clinical staff across the organisation to raise awareness and understand needs. This has all informed the development of an online training module that was release last week to ensure staff have a good understanding of VAD and their roles and responsibilities.

A suite of other materials have been developed to help staff and is available on a dedicated paged on The Hub. This includes specific information sheets for different disciplines who may deal with patients asking about VAD, Austin Health's policy and procedure, FAQs, and various other resources that have been developed by DHHS.

How many patients are we expecting to access VAD through Austin Health?

Modelling done by DHHS estimates that there may be between 100 and 150 patients across Victoria who may wish to end their life using voluntary assisted dying. While it's hard to know, at Austin Health we're think this may be around ten a year however we are likely to experience many more conversations about VAD.  Despite this, it's important that our staff have an understanding of VAD and how to respond to a patient should they raise it.

Are all health services participating?

The legislation recognises that this is a complex issue and not all health services and health practitioners will want to participate. Some faith-based health services are conscientiously objecting on religious grounds while others are making information available to patients about VAD but are not providing consulting doctors to assess patients. A large number of health services have taken a similar approach to us and have agreed to support eligible patients in their right to ease their suffering by ending their life at a time and place that they choose and at the same time, recognising that participation by staff is voluntary.

What happens to the patients of health services who don't participate?

DHHS has appointed Statewide Navigators who will assist patients from anywhere around the state to find practitioners who can assess them in line with the VAD legislation.

What should staff do if a patient implies the want to end their life but don't make a clear request to access VAD?

We've created communications materials for clinical staff that include a guide for how to manage these conversations. Staff should undertake the usual clinical assessment process when a patient implies that they want to end their life but don't make a clear and unambiguous request for VAD. This includes acknowledging the statement, asking more questions to understand what they're feeling and thinking, and assessing their physical and psychological symptoms.

We believe that the majority of these people are actually just requesting held to east their suffering through other options and not actually wanting to end their life. Staff are prohibited from raising VAD with a patient unless the patient has already made a clear and unambiguous request for information or access to VAD.

What advice would you give staff who are unsure of how to help patients who want to access VAD?

Voluntary assisted dying is a specialised area and it's not the responsibility of any one staff member to follow up every aspect for their patient. We know this is a very sensitive topic and that's why we have resources available on The Hub to help guide conversations between staff and patients.

VAD is an elective procedure so even when a patient decides they want to end their life it is not an emergency and we should take time out to ensure that we follow the correct process and use the supports that are available. The VAD Program Manager role is in place to help staff and I can be contacted any time during business hours to discuss the needs of either staff or patients.

For more information and support materials visit Hub/VAD

Kat Penna, Austin Health's VAD Program Manager, can also be reached on pager 2052 or email voluntaryassisteddying@austin.org.au