Voluntary Assisted Dying - Understanding the Process and Your Options with VAD Navigator Nicky Stitt

Voluntary assisted dying is something many of us know exists, but very few of us understand until we or someone we love is facing an advanced, life-limiting illness.

In this episode of Rest Easy Knowing, Fiona speaks with Nicky Stitt, a registered nurse and VAD Navigator with the Victorian Statewide Voluntary Assisted Dying Navigator Service.

Nicky explains what voluntary assisted dying actually is, who may be eligible, what the assessment process involves and, importantly, the role of the care navigator in supporting patients and their families.

This is not a conversation about persuading anyone to choose VAD. It's about understanding an end-of-life option that is available under Australian law and knowing where to turn for accurate information and support.

In this episode

We talk about:

• What voluntary assisted dying is — and what it isn't
• The strict eligibility requirements
• Why the decision must be the person's own
• The importance of maintaining decision-making capacity throughout the process
• How the VAD assessment process works
• The role of the VAD Navigator
• How navigators support patients, families and health professionals
• Why regional and rural access can be more complicated
• The importance of gathering medical and identity documentation
• Why establishing a person's prognosis can sometimes be difficult
• How long the VAD process generally takes
• What can happen when someone is very close to the end of their natural life
• Why some people begin the process but don't ultimately use the medication
• Common misconceptions about VAD
• The importance of knowing about VAD before you urgently need it
• How family members can support someone considering VAD

What is voluntary assisted dying?

Nicky explains that VAD involves a person making a conscious decision about whether they want to access medication that can bring about their death, subject to strict legal eligibility requirements.

The decision must be made by the person themselves. They must have decision-making capacity and maintain that capacity throughout the assessment process and when they choose whether or not to take the medication. Another person cannot make that decision on their behalf.

In Victoria, current eligibility requirements include being aged 18 or over, being an Australian citizen or permanent resident, having lived in Victoria for at least 12 months, having an advanced disease that is expected to cause death within the relevant timeframe, and experiencing suffering that is unacceptable to the person. (Health Victoria)

What does a VAD Navigator do?

This is one of the most useful parts of the conversation.

VAD Navigators aren't there simply to process paperwork. They provide information and support to patients, families, carers and health professionals, and can help connect people with doctors and other services.

Nicky describes the role as a central source of support — particularly because doctors may be providing VAD care alongside their broader medical responsibilities. Navigators can bring additional nursing or social-work perspectives to the process and help patients and families work through practical issues.

The Victorian Government similarly describes care navigators as nurses and allied health professionals who can explain the process, help people find eligible assessing doctors and connect patients and families with appropriate support. (Health Victoria)

How long does the process take?

Nicky explains that the process generally takes around four to six weeks in metropolitan areas, although it can take longer in regional areas because of access to doctors.

For people with some neurodegenerative conditions, an additional specialist assessment can extend the timeframe further.

In some circumstances, where a person is very close to the end of their natural life and the necessary doctors and requirements are in place, some timeframes may be shortened. Nicky says this is relatively uncommon.

That makes one message particularly important: don't wait until the last minute to find out how the process works.

The paperwork matters

One of the less obvious challenges Nicky discusses is documentation.

Navigators may need to establish a person's identity, citizenship or residency and gather medical information about their diagnosis, treatment and prognosis.

Sometimes obtaining documents such as birth certificates can take significant time. Navigators may also need to work with a person's GP, specialists and hospitals to build a clear picture of their medical circumstances.

Regional access

Access can be more challenging outside metropolitan areas.

Navigators may travel significant distances to meet people face-to-face, while access to doctors who can undertake the necessary assessments can be more limited.

That doesn't mean people in regional areas can't access support. It does mean that planning ahead can be particularly important.

A conversation worth having before you need it

Perhaps the biggest takeaway from this episode is that information is power.

You don't have to make a decision about VAD simply because you learn about it. You don't have to proceed once you start exploring it. But understanding the option, the eligibility requirements and the process means you and your family aren't trying to work it all out during a crisis.

The Victorian Government confirms that a person can change their mind at any point during the process, including before taking the medication. (Health Victoria)

Where to get help in Victoria

If you or someone you know is considering VAD, the Victorian Statewide Care Navigator Service provides information and support.

Phone: (03) 8559 5823
Email: vadcarenavigator@petermac.org

The service can also help connect people with a doctor who is willing and qualified to assist with the VAD process. (Health Victoria)

Similar services exist in other Australian states and territories. 

Important note

This episode provides general information and is not medical or legal advice.

VAD legislation and processes differ between Australian states and territories and can change over time. If you are considering VAD, speak with your doctor, healthcare team or the relevant VAD care navigator service for current information about your circumstances.

About Rest Easy Knowing

Rest Easy Knowing is a podcast about death, dying and the practical conversations we often avoid — helping make the unfamiliar a little less daunting and giving you information you can actually use.

This episode was recorded at Emerald Hill Heritage Centre on the traditional lands of the Boonwurrung people of the Kulin Nation. Fiona pays respects to Elders past and present and to all First Nations people listening.

Music by Sapiros.