Monash study proves world-leading safety and peace of mind in voluntary assisted dying
Monash University
New research demonstrates the Victorian model for oral self-administration of voluntary assisted dying (VAD) medication is safe and effective, providing the largest global experience of patient outcomes.
The study, published in the journal BMJ Supportive & Palliative Care, analysed the first six years of experience in Victoria, the first Australian state to make voluntary assisted dying available in Australia. The findings, from 2019 through to 2025, show the medication self administered by patients in Victoria reliably leads to death without the potential complications associated with multi-drug combinations used in other countries. This research offers important reassurance for patients, families and clinicians.
The six-year study provides a roadmap for healthcare systems to implement compassionate, evidence-based end-of-life care.
Lead author Professor Michael Dooley, from the Centre for Medicine Use and Safety at the Monash Institute of Pharmaceutical Sciences and Director of the Victorian Voluntary Assisted Dying Statewide Pharmacy Service, said the findings cement the Victorian model’s status as a benchmark for the safe and effective self-administration of voluntary assisted dying medication.
“Our world-first data provides definitive evidence that the Victorian model is a global benchmark for safety and provides reassurance for patients, families and clinicians that voluntary assisted dying is working as intended, supporting compassionate and informed choice at end-of-life,” Professor Dooley said.
“The focus is providing compassionate and safe care for those considering voluntary assisted dying and providing information and evidence to inform those decisions. The Victorian approach, supported by many wonderful practitioners, including doctors, nurses and pharmacists, has shown that terminally ill patients can safely self-administer medication to end their life if they choose to.”
There are a range of key safeguards in place in Victoria to support patient self-administration of the oral medication and these have been crucial in providing the outcomes reported here.
The study also highlights the vital role of the Victorian Voluntary Assisted Dying Statewide Pharmacy Service in supporting patients and their families and carers. Pharmacists assess the patient’s knowledge and decision-making capacity, as well as their ability to swallow the medication prior to providing the medication.
“Compared with some older international practices that use more complex multi-drug combinations, the medication protocol used in Victoria has been shown to provide a safe, effective and more consistent experience for patients,” Professor Dooley said.
As jurisdictions worldwide continue to consider making voluntary assisted dying available, the Victorian experience serves as a global benchmark for adoption.
Read the research paper: doi.org/10.1136
RESEARCHERS
This research was led by Professor Michael Dooley from the Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences at Monash University, and the Victorian Voluntary Assisted Dying Pharmacy Service. He was joined by Tien Nguyen, Phuc Phan, and David Seymour, all of the Victorian Voluntary Assisted Dying Statewide Pharmacy Service at Alfred Health.
This work was supported by the Alfred Hospital Ethics Committee (Reference Project 521/23). The authors declare no competing interests.
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