Go Gentle Australia VAD Conference 2024 - Summary

Summary of the Go Gentle Australia VAD Conference 2024

With the permission of Go Gentle Australia (GGA), Dying with Dignity WA is pleased to provide this summary of the official report of VADCON24, the second annual trans-Tasman voluntary assisted dying conference held in Brisbane in October 2024.

The three-day conference was hosted by GGA and delivered in partnership with VADANZ (the peak body for VAD health professionals) and QUT’s Australian Centre for Health Law Research. It was attended by a number of important stakeholders in different aspects of VAD, including health professionals, policymakers and researchers.

This summary does not purport to cover the full range of discussions, research and insights from the conference. The full report can be found on the Go Gentle Australia website at https://www.gogentleaustralia.org.au/2024_conference_report

Key themes

The over-arching theme of the conference was ‘Access and Equity’ with four underlying sub-themes:

VAD is not yet an established end of life option

Notwithstanding the growing demand for VAD, public awareness and health professional participation need to be increased for VAD to become fully established as an end of life choice.

There were promising signs that palliative care and VAD were not at odds with each other, with the view of the overwhelming majority of palliative care workers being that VAD had no effect on or actually increased the demand for palliative care.

Greater support needed to secure future VAD workforce and services

The sustainability of the VAD workforce is a concern in all jurisdictions. Ways to ameliorate this were discussed, including by encouraging the increased participation by health professionals through

  • appropriate remuneration;
  • the possible simplification of the VAD process and training and adding VAD modules to university curricula; and
  • augmenting participation in the VAD process by nurse practitioners.

Removing limits on VAD discussions would improve patients’ experience

Conference participants agreed that open discussions about VAD were essential to high quality VAD care, which would be improved by removing:

  • the limits on such discussions imposed by the “Telehealth’ restrictions under the Commonwealth Criminal Code; and
  • the ‘gag clauses’ in Victoria, South Australia and New Zealand.

People seeking VAD continue to face inequities of access

The factors that affect a person’s access to VAD include

  • the time to death prognosis eligibility criterion. The conference favoured the ACT criterion that the person’s condition must be ‘advanced, progressive and expected to cause death’ and that the person must be ‘approaching the end of their life’;
  • the likelihood of losing capacity;
  • where the person is cared for, especially if the person lives in an aged, hospice or palliative care facility that is opposed to VAD;
  • where the person lives, since the current residency requirements can mean otherwise eligible people are denied access to VAD on the basis of the location of their care.
  • in some states, including Western Australia, access to VAD in remote regional areas is more limited*.

*Note added by DWDWA

The Program highlights can be found on slide 6 of the report.

Research highlights are on slide 7.

Survey

At the end of the conference, delegates were asked to rank their priorities in relation to three key issues:

  1. VAD Reform
  2. What would improve the experience for people seeking VAD; and
  3. How can we boost the number of VAD health professionals.

Survey Results

The results and analysis of the survey can be found on pages 8 and 9 of the report.

The top five responses in relation to each of the key issues are set out below in order of ranking:

Reform

  1. Allow use of telehealth and electronic communications in VAD practice.
  2. Standardise or remove timeframes to death.
  3. Raise awareness and improve understanding of VAD.
  4. Increase the number of VAD health professionals.
  5. Remove state residency requirements.

Improve the VAD Experience

  1. Reduce or remove limits on open discussion.
  2. Increase awareness and understanding of VAD and end of life.
  3. Standardise or remove timeframes to death.
  4. Easier access to VAD health professionals.
  5. Reduce process length and complexity.

Boost the number of VAD health professionals

  1. Improve remuneration.
  2. Increase awareness / acceptance of VAD.
  3. Greater collaboration between VAD and palliative care.
  4. Reduce administrative complexity.
  5. Increase peer support structures.

The analysis of the survey results shows:

The most common reasons people leave the VAD workforce are:

  1. Workload
  2. Remuneration
  3. Emotional toll

80% of respondents see themselves working in the VAD field in five years.

69% believe that prognosis timeframes (e.g. 6-12 months to live) are an unnecessary safeguard.

64% have personally, or via a close colleague, been aware of a VAD patient obstructed or denied access to VAD by a non-participating institution.

86% agree that residency requirements should be standardised now VAD is legal everywhere except the NT.

73% support a patient already approved for VAD being able to nominate someone to provide final consent in the event they lose capacity.

DWDWA is grateful to GGA for giving its permission for this summary to appear on the DWDWA website and in its Autumn Newsletter.