Scope of practice for medical practitioners and other 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 medical practitioners and other healthcare workers in voluntary assisted dying.

Table 1. Overview of the scope of practice for 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

Medical practitioners can choose their level of involvement with voluntary assisted dying. For example, an eligible medical practitioner:

  • may be comfortable providing a patient with general information but can choose to take no further part
  • can choose to be the coordinating practitioner, but not the administering practitioner
  • can choose to be the coordinating practitioner for a person with whom they’ve had a longstanding doctor-patient relationship, but not for another person.

Medical practitioners should check whether their workplace has specific policies in place regarding voluntary assisted dying.

Medical practitioners can refuse to participate in any part of voluntary assisted dying for reasons including:

  • a conscientious objection to voluntary assisted dying
  • not having the appropriate skills or training to be involved in the process
  • not being available to assist the person through the process.

Learn more about medical practitioner legal obligations if they choose not to participate.

Medical practitioners who meet the eligibility requirements, have completed the mandatory training, and are approved by the Chief Medical Officer of Queensland Health 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.

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
  • Receives first, second, and final requests from the person
  • Conducts first eligibility assessment and final review
  • Assists the person with making their administration decision
  • Prescribes the voluntary assisted dying substance
  • As a default, acts as administering practitioner (for practitioner administration)

Medical practitioner who has completed mandatory training and been authorised by the Chief Medical Officer prior to conducting the first assessment

Consulting practitioner

  • Conducts second eligibility assessment

Medical practitioner who has completed mandatory training and been authorised by the Chief Medical Officer prior to conducting the consulting assessment

Administering practitioner

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

Coordinating practitioner (default). Role can be transferred to another eligible medical practitioner, nurse practitioner, or registered nurse who has completed mandatory training and been authorised by the Chief Medical Officer

Nurse practitioner and registered nurse roles

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

Nurse Practitioner

Registered Nurse

Can

Cannot

Can

Cannot

  • 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 the administering practitioner if the coordinating practitioner transfers this role to them AND they have been authorised as a VAD practitioner.
  • Act as a coordinating or consulting practitioner.
  • Act as a coordinating or consulting practitioner.
  • Initiate a conversation about voluntary assisted dying.

Information for nurse practitioners and registered nurses

People with questions about voluntary assisted dying, including those who may be considering it as an end-of-life option may approach a nurse practitioner or registered nurse involved in their care to request information.

Factsheets of frequently asked questions for nurse practitioners and registered contain essential information about voluntary assisted dying:

Roles for healthcare workers

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.

All healthcare workers should continue to provide care to people who are considering or have requested access to voluntary assisted dying. Healthcare workers should review and follow their organisation’s policies and procedures for voluntary assisted dying, while also complying with the legislation and supporting their patient’s choice and autonomy.

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 if they receive a referral for determination from a coordinating or consulting practitioner.

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.

All healthcare workers have the right to refuse to participate in all or any stage of the voluntary assisted dying process. For example:

  • a nurse practitioner may be comfortable providing a patient with general information but can choose to take no further part in the process.
  • an eligible registered nurse can choose to be the administering practitioner for a person with whom they’ve formed a therapeutic nurse-patient relationship, but not for another person
  • a psychologist may be willing to accept a referral for determination of decision-making capacity for voluntary assisted dying for a person with whom they have a longstanding therapeutic relationship, but not for another person
  • a social worker may provide bereavement counselling for the spouse of a person who has died by voluntary assisted dying but choose to not be directly involved in the voluntary assisted dying process.

If a healthcare worker refuses to participate they still have obligations under the Act. Read more about these obligations.

Pharmacist roles

Find out more about authorised suppliers and disposers of the voluntary assisted dying substance.

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 support for the family.

However, first responders usually have a duty to administer life-sustaining 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 from a person they believe on reasonable grounds is dying after administration of the voluntary assisted dying substance is protected by the Act. This is on the basis that the patient has not directly requested life-sustaining treatment.

Information for ambulance officers (PDF 651 kB).

Home care workers

Home care worker fact sheet (PDF 310 kB)

Last updated: 12 May 2023