New South Wales is implementing voluntary assisted dying (VAD) laws this week. 

NSW, the last Australian state to introduce such legislation, has outlined new laws covering the process for terminally ill individuals to request to end their lives.

Terminally ill individuals with an advanced and progressive disease, illness, or medical condition expected to cause death within six months (or 12 months for neurodegenerative diseases) are eligible. 

They must be at least 18 years old, an Australian citizen, permanent resident, or a resident of Australia for at least three years. NSW residency for at least 12 months is required unless an exception is granted. 

The applicant must have decision-making capacity, the ability to choose without coercion, and an ongoing request.

Patients initiate the process by requesting VAD from a doctor, preferably their GP, who must have undertaken specialist VAD training. 

If the doctor lacks the required training, the applicant can seek a trained doctor through the NSW Voluntary Assisted Dying Care Navigator Service. 

The request must be approved or rejected within two days, with the option for doctors to refuse on conscientious objection grounds.

Upon approval of the initial request, the coordinating practitioner oversees the process. A second eligible doctor performs a consulting assessment, informing the patient about VAD, treatment, and palliative care options. If both doctors deem the applicant eligible, the patient completes a written declaration. 

After a final request at least six days later, the coordinating practitioner conducts a final review, ensuring all criteria are met. The patient then decides how to take the medication, either self-administering or having a doctor or nurse assist.

The coordinating doctor applies for a VAD substance authorisation, approved by the Voluntary Assisted Dying Board. 

Safeguards include the ability for the patient to stop or pause the process, three separate requests, decision-making free from pressure, and oversight by the Voluntary Assisted Dying Board. Persuading patients to access VAD outside the formal process is an offence.

Medical practitioners in NSW can conscientiously object, allowing them to refrain from participation. 

They are not required to obstruct a patient from accessing information or interfere with the process.

The NSW VAD scheme aligns with other states but differs in certain aspects. 

Unlike Victoria and South Australia, practitioners in NSW can raise VAD as an option. Patients in NSW have the choice of self-administering the medication, unlike Victoria and South Australia where practitioners must administer if the patient is unable. 

Conscientious objection rules vary, with NSW, Victoria, Queensland, and South Australia allowing non-participation, while Western Australia and Tasmania mandate information provision regardless of objections.

The NSW legislation emphasises legal protections for those acting in good faith and supporting individuals accessing VAD. Implementation begins this week.