Voluntary assisted dying is lawful in all Australian states^[1]. This allows terminally ill adults who are suffering and have decision-making capacity to choose to receive help to die.

Victoria’s law was the first, coming into effect in 2019^[2]. New South Wales was the last state, with its voluntary assisted dying law^[3] beginning in late 2023.

Voluntary assisted dying will be allowed in the Australian Capital Territory^[4] in November, and a Northern Territory report^[5] has recommended it pass a voluntary assisted dying law too.

While the vast majority of Australians now live in jurisdictions where voluntary assisted dying is permitted, accessing voluntary assisted dying depends on knowing it’s a legal option. But our new research^[6] suggests many Australians don’t know this.

A study in Queensland

Voluntary assisted dying became legal in Queensland^[7] on January 1, 2023. We conducted an online survey^[8] of 1,000 Queensland adults in mid-2024 to find out if the community knew about this new end-of-life choice.

We set quotas for age, gender and geographical location to ensure the people we surveyed represented the overall Queensland population.

First, we asked whether people thought voluntary assisted dying was legal in Queensland. Only one-third (33%) correctly identified^[9] it was. Of the 67% who didn’t, 41% thought voluntary assisted dying was illegal and 26% said they didn’t know.

People who did know voluntary assisted dying was legal had generally found out in one of three ways:

• from the media

• from professional experience (for example, working in health care)

• from personal experience (for example, knowing someone who had asked about, requested or accessed voluntary assisted dying).

We then told our survey participants voluntary assisted dying was legal in Queensland and asked if they would know how to go about accessing it if they wished to. Only one-quarter (26%) answered yes.

The survey also asked people where they might look for information about voluntary assisted dying. Most people said they would seek this information online, but asking health practitioners, especially doctors, was also important.

We found two-thirds of people didn’t know voluntary assisted dying was legal. Ground Picture/Shutterstock^[10]

Legal and cultural barriers

Perhaps it’s not surprising so few members of the surveyed public know voluntary assisted dying is a legal choice. It’s still a relatively new law. But there are specific barriers^[11] in Australia that can prevent people finding out about it.

One major barrier is health practitioners are often not able to freely discuss^[12] voluntary assisted dying with their patients. The laws in all states control how conversations about voluntary assisted dying can occur.

For example, in Queensland, only doctors and nurse practitioners can raise voluntary assisted dying^[13] and only if they also discuss available treatment and palliative care options and their likely outcomes.

But the most problematic are Victorian^[14] and South Australian^[15] laws which prohibit health practitioners from raising the topic with patients altogether. Many people rely on their doctor to tell them about treatment options, so it’s a problem if the onus is on the patient to bring it up first.

Conscientious objection^[16] is another significant barrier. Some doctors are opposed to voluntary assisted dying and even if they practise in a state where they can legally raise it, may choose not to tell their patients about it. This is another reason patients may not know voluntary assisted dying could be a choice for them.

It’s important to note our study was only done in Queensland, so we can’t be confident the findings represent the wider Australian population. But given these barriers to knowing about voluntary assisted dying, it’s reasonable to anticipate similar trends in other states.

A national challenge

Raising community awareness of voluntary assisted dying is a challenge around the country. Voluntary assisted dying oversight boards from five states (Queensland^[17], Tasmania^[18], Victoria^[19], Western Australia^[20] and South Australia^[21]) have all discussed this issue in their most recent annual reports.

In addition, Western Australia recently reviewed its voluntary assisted dying laws, identifying lack of community knowledge as a problem. The review called for a strategy^[22] to fix this.

We see this challenge as one of “voluntary assisted dying literacy”. Greater voluntary assisted dying literacy will enable members of the public to know the options available to them, and how to make the choices they want.

Raising community awareness about voluntary assisted dying is a challenge nationally. Tero Vesalainen/Shutterstock^[23]

What can we do about this?

We need community awareness initiatives to increase knowledge that voluntary assisted dying is legal and ensure people know where to find information about this option. Information about voluntary assisted dying is already available from all state government health departments^[24], but more action is needed to ensure it reaches more people.

Respondents in our survey suggested using social media campaigns, advertising, and sharing information through Centrelink, health clinics and other trusted community channels.

We also propose targeted information for particular patient groups who may be eligible for voluntary assisted dying, such as people with cancer or neurodegenerative diseases. This means they will know voluntary assisted dying may be one of the treatment options available to them, and how to navigate the process should they wish to.

These initiatives would need to be designed sensitively with a focus on providing information to avoid any perception that people could feel induced or directed to access voluntary assisted dying.

Training for health practitioners is also important. This is particularly needed for GPs and specialists working in end-of-life care. Training will support health practitioners to facilitate informed discussions with patients and families.

Strong community support was a key argument^[25] in legalising voluntary assisted dying in Australia. The public wanted this as an end-of-life choice. But that choice is only a real one if people know it exists.

Our online resource End of Life Law in Australia^[26] has more information about voluntary assisted dying and contact points for accessing it in each state.

References

1. ^{^} all Australian states (www.unswlawjournal.unsw.edu.au)
2. ^{^} in 2019 (theconversation.com)
3. ^{^} voluntary assisted dying law (theconversation.com)
4. ^{^} allowed in the Australian Capital Territory (www.act.gov.au)
5. ^{^} Northern Territory report (cmc.nt.gov.au)
6. ^{^} new research (www.tandfonline.com)
7. ^{^} in Queensland (www.health.qld.gov.au)
8. ^{^} an online survey (eprints.qut.edu.au)
9. ^{^} one-third (33%) correctly identified (research.qut.edu.au)
10. ^{^} Ground Picture/Shutterstock (www.shutterstock.com)
11. ^{^} specific barriers (onlinelibrary.wiley.com)
12. ^{^} not able to freely discuss (onlinelibrary.wiley.com)
13. ^{^} can raise voluntary assisted dying (classic.austlii.edu.au)
14. ^{^} Victorian (classic.austlii.edu.au)
15. ^{^} South Australian (www.austlii.edu.au)
16. ^{^} Conscientious objection (onlinelibrary.wiley.com)
17. ^{^} Queensland (www.health.qld.gov.au)
18. ^{^} Tasmania (www.health.tas.gov.au)
19. ^{^} Victoria (www.health.vic.gov.au)
20. ^{^} Western Australia (www.health.wa.gov.au)
21. ^{^} South Australia (www.sahealth.sa.gov.au)
22. ^{^} review called for a strategy (www.parliament.wa.gov.au)
23. ^{^} Tero Vesalainen/Shutterstock (www.shutterstock.com)
24. ^{^} state government health departments (www.health.qld.gov.au)
25. ^{^} key argument (www.parliament.vic.gov.au)
26. ^{^} End of Life Law in Australia (end-of-life.qut.edu.au)