Workforce strain, federal telehealth restrictions and obstruction still limit equitable access to voluntary assisted dying in Australia, according to a new report .
Voluntary assisted dying is delivering on its promise as a safe, compassionate end-of-life option for terminally ill Australians, but major access barriers remain and rising demand is putting pressure on an already stretched clinical workforce.
That is the central finding of Go Gentle Australia’s 2026 State of VAD report out today, which draws on publicly available data from oversight bodies around the country and concludes that VAD has become an established part of end-of-life care alongside palliative care.
Go Gentle Australia chief executive Dr Linda Swan described VAD as a “public policy success story”.
“The evidence paints a reassuring picture where Australia’s laws work as intended, services deliver compassionate care, and dying people can choose the comfort they want at the end of life,” she said.
However, she noted that the increased public demand for VAD services raised concerns about workforce capacity and long-term sustainability.
“As more people ask for access to VAD we must ensure the system is properly resourced to support both patients and clinicians,” Dr Swan said.
“Funding shortfalls and inadequate remuneration place strain on providers. Many VAD health professionals work after hours and on weekends and receive little or no financial compensation.”
The report revealed that about 14,000 people have applied for VAD since the first laws came into effect in Victoria in 2019. There have been more than 7000 deaths using a VAD substance.
VAD activity increased by approximately 40% nationwide in 2024-25, with the largest growth in Tasmania, followed by Western Australia, South Australia and Queensland.
A typical VAD applicant is a man in his mid-70s with terminal cancer who is already receiving palliative care, according to the report. More than 80% of applicants were accessing palliative care services, reinforcing the message that VAD and palliative care were working in parallel rather than in opposition.
Although VAD still represents only around 2% of deaths nationally, uptake is higher in specific disease groups, accounting for 5% of cancer deaths and up to one in three deaths from motor neurone disease.
The report said this reflected the growing acceptance of VAD as a legitimate end-of-life pathway for some patients with advanced disease.
The report went into detail about workforce sustainability emerging as a serious concern in the provision of VAD in Australia.
While there were now more than 1600 trained VAD practitioners nationwide, fewer than half provided VAD care during the reporting period.
In some jurisdictions, a small cohort of clinicians was carrying a disproportionate share of the workload, often with limited or no remuneration, particularly in general practice.
The report identified Commonwealth restrictions on telehealth as one of the most significant barriers to equitable access.
Because of the interaction between state VAD laws and the federal Criminal Code, much of the VAD process still cannot be conducted via electronic communication, forcing patients to attend repeated face-to-face consultations or wait for clinicians to travel long distances, even in cases of severe frailty or advanced illness.
Go Gentle founding director Andrew Denton said the telehealth restriction was especially harsh on patients in regional areas, arguing it caused unnecessary distress and delay and should be addressed through a simple amendment to federal law.
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“It is unreasonable and cruel to require dying people, especially those living in regional areas, to travel long distances for in-person appointments at every step of the process, particularly when safe and effective alternatives exist,” Mr Denton said.
“It is a simple one-line fix to amend the Commonwealth Criminal Code to allow the use of electronic communications in VAD provision.
“It is an equity issue, but there appears to be resistance at very senior levels of the federal government, based on outdated views.”
The report also raised concern about obstruction by individual clinicians and institutions, and said objection should not extend to conduct that delays or blocks access for eligible patients, particularly when that conduct caused distress or undermined person-centred care.
“A right to conscientiously object to being involved in VAD is a cornerstone of Australia’s VAD laws. But a right to object should never become a right to obstruct,” Mr Denton said.
“Evidence shows that obstruction can cause serious distress and harm to dying people and their families. It is also unethical and against professional codes of conduct and must be addressed.”
Access problems extend beyond legal barriers, the report found. Up to 40% of people who began the VAD process did not complete it, with some dying before the process was finalised and others becoming too unwell to continue.
It pointed to process complexity, paperwork burden and difficulty finding trained practitioners, especially outside metropolitan areas, as persistent problems.
Despite that, the compliance picture remained strong. Oversight bodies across jurisdictions reported near-universal adherence to legislative safeguards, with the few breaches identified largely administrative in nature and not affecting patient eligibility or safety.
No VAD deaths in the 2024-25 reporting period were referred by oversight bodies to police or coroners.
The report concluded that the policy debate has shifted. The key question was no longer whether VAD laws were appropriate, but whether governments would remove unnecessary barriers, strengthen workforce capacity and ensure access remained equitable as demand continued to grow.
One of the biggest challenges remained ongoing stigma and limited public awareness of VAD. Surveys show just one in three people are aware that VAD is now legal, said Dr Swan.
“People can only benefit from the VAD choice if they know it exists,” she said.
“Governments and health information providers must play a greater role to make sure people are aware of and informed about their end-of-life options.”
Mr Denton said progress on end-of-life choice had been significant since Go Gentle’s founding 10 years ago, but more work was needed.
“The Northern Territory has yet to pass VAD legislation. Territorians deserve the same end-of-life choices as other Australians,” he said.
“Existing laws must also be protected and improved to ensure access for all eligible people.”
The full report is available on the Go Gentle Australia website here.
