Voluntary assisted dying in Australia: The current state of play

Warning: This article contains details about death and suicide which may be upsetting for some readers. Reader discretion is advised.

Voluntary assisted dying is now legal across all Australian jurisdictions except the Northern Territory. Variations across jurisdictions include differences in assessment requirements, institutional responsibilities, and prognosis timeframes, alongside ongoing debate about the role of telehealth and evolving medical and legal perspectives on end-of-life care.

Overview of developments

Since our December 2023 article, Voluntary Assisted Dying in Australia: What you need to know, every jurisdiction except for the Northern Territory (NT) has passed voluntary assisted dying (VAD) legislation, with Victoria being the first state to implement the laws. These laws legalise the medical process that gives eligible individuals the option to end their suffering by choosing to die through the administration of an approved substance.¹

These updates are particularly important for medical practitioners, hospitals, healthcare workers and individuals alike, as VAD laws in Australia are governed by a stringent legislative framework – considered to be one of the most tightly regulated forms of healthcare. Regardless, studies suggest there remains limited understanding about how these regulations operate at the frontline.²

The Australian model of VAD has some jurisdictional variations but is characterised by prescriptive legislation that limits access to terminally ill adults who meet eligibility criteria, as assessed by at least two qualified and experienced healthcare professionals.³ Practitioners are subject to strict reporting requirements throughout the process.

Where is VAD legal?

The Australian territories have been last to legislate on VAD, having previously been prohibited from doing so under Commonwealth law. This changed in 2022 with the passing of the Restoring Territory Rights Act 2022 (Cth), which repealed restrictions preventing the NT and the Australian Capital Territory (ACT) from legislating on VAD. As such, ACT legislation will come into effect on 3 November 2025 and its implementation will be monitored closely by the NT, which is now the only jurisdiction without VAD legislation.

VAD to be introduced in ACT

The ACT legislation generally reflects what is now referred to as the 'Australian model' of VAD. Access is available for those who are terminally ill and meet strict eligibility criteria assessed by two independent and trained health practitioners. In order to access VAD in the ACT, individuals must be:

1. aged 18 years and over
2. a resident in the ACT for the preceding 12 months or granted an exemption
3. diagnosed with an advanced and progressive medical condition that will cause death and is causing intolerable suffering
4. able to make and communicate decisions throughout the process.

Key changes in ACT legislation

Despite ACT legislation being considered generally to reflect the Australian model of VAD, there are substantial variations in the legislation compared to other jurisdictions. These differences have been debated since the introduction of the legislation and examined closely by a parliamentary committee, including:

1. Timeframe for prognosis

Patients seeking VAD do not need a specific timeframe of prognosis compared to other states that have imposed a six or 12-month period. Rather, ACT eligibility criteria requires that the individual has an 'advanced condition'. A condition is defined as 'advanced' if they are approaching the end of their life with a decline in functioning and quality of life with no prospect of improvement or effective treatment.

2. Who can assess eligibility

A nurse practitioner can assess eligibility for VAD in the ACT. This is in contrast to other states which require two doctors.

3. Conscientious objections

The ACT legislation creates an offence in certain circumstances where institutions (e.g. hospitals) with a conscientious objection to VAD fail to facilitate a transfer of an individual to another facility to access VAD. Queensland and New South Wales have legislation outlining the referral obligations of medical practitioners, with South Australian laws extending to obligations of facilities. However, by creating an offence, the ACT gives greater emphasis to the rights of individuals temporarily in institutions that object to VAD, compared to other jurisdictions.

Debate over eligibility criteria and dementia in ACT

With the implementation of the ACT legislation and proposed legislation in the NT, debate continues over whether VAD should be extended to conditions such as dementia, which affect decision-making capacity.

The ACT government has committed to considering access to VAD for individuals who have lost decision-making capacity, with the issue scheduled for review three years after enactment.⁴ The review will consider whether access to VAD should be available for individuals who have lost decision-making capacity, through advanced care planning. In contrast, NSW legislation specifically references dementia, stating that an individual is not eligible merely because of a dementia diagnosis. While ACT law does not specify a timeframe or directly address dementia, it is unlikely that an individual's condition would reach the 'advanced stage' while retaining the decision-making capacity required throughout the VAD process.

With increased public discussion around conditions that affect decision-making capacity, debate is expected to continue as jurisdictions navigate the complex ethical considerations of ensuring VAD remains both safe and accessible to Australians.

Developing a VAD framework in NT

This leaves only the NT without any VAD legislation. In July 2024, an expert advisory panel commissioned by the Labor Government handed down its final report recommending that VAD be made available to NT residents.⁵ Responsibility for progressing this recommendation rests with the Legal and Constitutional Affairs Committee, which has been tasked with consulting NT communities on VAD and, if supported, preparing draft instructions for a new law. The committee is required to report back by 30 September 2025.

The report canvassed a strong desire among territorians for individuals diagnosed with dementia to have access to VAD. Despite that, the panel recommended a dementia diagnosis should not feature in the NT's eligibility criteria, and recommended against allowing VAD to feature within an advance personal plan or advance health care directive. In doing so, the report is consistent with other Australian jurisdictions where individuals are precluded from accessing VAD without the requisite capacity.

How the NT approaches VAD legislation remains to be seen, particularly given the unique cultural and geographical factors at play, including the remoteness of many communities and cultural considerations relevant to the Aboriginal and Torres Strait Islander peoples. We will monitor developments over the coming months with interest, including the potential role of telehealth to address these logistical challenges.

Telehealth developments

Health practitioners must be aware that under the Criminal Code Act 1995 (Cth) (Criminal Code), it is a criminal offence to use telecommunications (e.g. phone, email, or the internet) to disseminate 'suicide related materials', which may extend to providing advice to patients about VAD.⁶ As Commonwealth law overrides state law, state legislation provides no protection to health practitioners whose conduct has potential to result in a criminal offence.

It remains contentious whether telehealth can be used in a limited capacity during the VAD assessment and consultation process. While certain aspects of the process, such as prescribing, would ordinarily be conducted electronically, doing so in these circumstances may contravene Commonwealth criminal law.⁷ This uncertainty is particularly concerning for health practitioners in light of the implications raised in the Carr decision.

Concerns about the potential unlawfulness of telehealth in the context of VAD has increased recently. The Australian Medical Association (AMA) has described the current use of telehealth for VAD as 'prohibited' and issued a statement urging the Attorney General to amend the Criminal Code so that health practitioners can provide VAD services via telehealth. This is consistent with the views of various advocacy groups seeking reform to ensure patients living in regional, rural and remote communities have equal access to end-of-life options.

Updated AMA position on VAD

The AMA is the peak professional body for doctors in Australia, influential in promoting and protecting their professional interests as well as the healthcare needs of patients and communities.

Since the AMA's previous statement in 2019 declaring that doctors should not be involved in interventions intended to end a person's life, it has acknowledged that VAD is a matter for government and society to determine. On 29 March 2025, the AMA released the following statement intended to support doctors and patients regardless of whether they choose to participate in VAD:

Doctors have an ethical duty to provide their patients with quality end of life care that strives to alleviate pain and suffering, supports an individual's values and preferences for care and allows them to achieve the best quality of life possible.

The statement aligns with the position under each state's legislation whereby doctors may conscientiously object to VAD, provided they inform the patient of their objection in a timely manner, refer them to another practitioner, and ensure the patient has sufficient information to exercise their right to access VAD.

Victoria scraps gag clause preventing doctors from raising VAD with patients

Victoria has reviewed its VAD legislation and decided to repeal a controversial 'gag clause' originally designed to prevent coercion. The gag clause refers to a provision which prohibits health practitioners from raising VAD with patients, essentially requiring individuals to be aware of their end-of-life options before consulting a doctor. Its removal will allow health practitioners in Victoria to initiate conversations about VAD with their patients, bringing Victorian legislation in line with other Australian jurisdictions. The amendments leave South Australia as the only remaining state or territory with the gag clause in place.

Developments abroad

The UK is on course to follow Australia, Canada and some US States in permitting VAD. On 20 June 2025, the UK Parliament passed the Terminally Ill Adults (End of Life) Bill, granting adults who are mentally competent and terminally ill with six months or less to live the right to choose VAD in England and Wales. The Bill will proceed to Britain's upper chamber, the House of Lords, where it will undergo months of scrutiny.

Footnotes

¹ Voluntary Assisted Dying Bill 2023 Supplementary Explanatory Statement (The Legislative Assembly for the Australian Capital Territory) accessed via Voluntary Assisted Dying Bill 2023 | Bills
² Regulating voluntary assisted dying at the clinical coalface: a qualitative interview study in Victoria, Australia (BMJ Quality & Safety, 2025)
³ Above
⁴ Voluntary Assisted Dying Bill 2023 (ACT) (as presented (includes compatibility statement)) p 26
⁵ Report into Voluntary Assisted Dying in the Northern Territory (Northern Territory Government, 2024)
⁶ Interpreted in Carr v Attorney-General (Commonwealth) 2023 FCA 1500
⁷ Joint statement: Electronic communications must be available for voluntary assisted dying

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.