Which aged care providers are ‘wilfully ignoring’ their federal obligations to provide, at the very least, information about voluntary assisted dying?
Some of Australia’s largest aged care providers have doubled down on their defence of refusing to provide voluntary assisted dying (VAD), or even information about VAD as an option to their residents.
VAD advocates warn that vague or absent information about VAD from providers means that older people risk being stuck in facilities that do not support assisted dying or will not help them access it if requested.
As The Medical Republic‘s sister publication Health Services Daily reported, a report from VAD advocacy group Go Gentle showed that almost three quarters of aged care providers in Australia either don’t offer VAD or don’t provide clear information to residents on how to access it, despite obligations to do so under the Commonwealth Aged Care Act, which takes precedence over state legislation.
And two thirds of residential aged care homes do not provide any public information about VAD in their facility or on their website, the report found. Only 10% of providers give comprehensive information and full access to VAD, which is legally available in every state and the ACT.
Some aged care providers, such as Uniting, Regis and Bupa, make it clear on their websites that they will support residents who request VAD.
But when The Medical Republic asked some of the biggest providers whether they would be providing public information about VAD, they defended their decision not to support VAD.
Calvary Health Care said it complied with VAD legislation by publishing information that explained that it does not provide VAD services.
Another Catholic provider, Mercy Health, said it does not provide VAD “for moral reasons”.
Opal Healthcare said it was aware that “private sector organisations are demanding greater detail on who chooses VAD”, without acknowledging that federal legislation requires them to do so.
In contrast, Uniting was one provider rated as a “best practice provider”, who said their focus was on “ensuring older people who live in our residential care homes or access our services in other ways have an equal right to access all legal end-of-life choices”.
Under the Aged Care Act, aged care residents have the right to choose VAD and have their choice respected, and aged care providers are legally required to meet federal obligations to provide access to VAD.
The Aged Care Quality and Safety Commission says providers that choose not to take part in VAD must still meet their legal obligations to support residents’ access to VAD, and that living in a residential care home does not impact a person’s right and ability to choose VAD.
“This is true even where the provider has made the decision not to participate in the VAD process, and in jurisdictions where there is no obligation for a provider to directly facilitate access to VAD services,” the ACQSC says.
Go Gentle CEO Dr Linda Swan said providers were ignoring their obligations to provide clear information about VAD, leaving older people and their families in the dark.
“They somehow don’t seem to understand or are wilfully ignoring their obligations to ensure people understand their end-of-life choices, and that voluntary assisted dying is a legal healthcare choice available at the end of life,” she told TMR.
“It is very clear from the Commission and from the principles within the Aged Care Act that providing this information is something that would be expected of them.
“If you knew that the person you were caring for, or if you had a very firm belief yourself that you would like the choice of assisted dying at the end of life … you might want to know that the facility you’re spending the last months and years of your life in offers access to assisted dying.
“So, if you wanted to find out, how would you know?
“The facilities are not providing this information, and yet we still got the type of responses that were not, ‘I’m sorry, let me fix that’.
“It’s more some sort of strange justification, which doesn’t seem to bear any resemblance to their actual obligations.”
Dr Swan said there was a gap between the information aged care providers were providing publicly and the experience of people trying to access information.
“People who are dying and approaching the end of their life – there is an extraordinary number of stresses on them. They don’t want to have to try and navigate some sort of corporate speak to interpret.
“It should be simple information, readily available. If someone asks for it, it should be provided without judgment.
“And then, even if the facility doesn’t have staff who can provide assisted dying services, they should help them find someone who can. That’s just common decency.
“If they really believed in a lot of their motherhood statements about person-centred care and patient autonomy, then this should be a no-brainer.
“Once you’re in a facility and you’ve chosen it, and that’s your new home. It’s extremely unreasonable to expect that anybody is going to be able to go, oh, well, never mind, I’ll move somewhere else.
“Once you’ve done that enormous, stressful move into a new facility for the last years of your life, you’ve often made a commitment, and you’re stuck. If you then find out that this facility doesn’t support assisted dying … it’s not a choice available for you.”
Dr Swan said residents of aged care facilities had the right to access voluntary assisted dying in the facility, which is their home.
“It might mean that somebody else has to come in and help deliver the care, but the facility cannot say no.”
Written information would arm residents with the information if their request for VAD was denied, Dr Swan said.
“We would love facilities to be open about their policy and their stance towards assisted dying, and then we would like that policy to have some evidence that it’s actually what happens in practice.
“If they say they allow full access, that we’re not getting stories from those facilities from people in those facilities that contradicts that, or if we do, then you have an avenue to raise a complaint.”
End-of-life care was the core business of aged care providers, Dr Swan said.
“Looking after people at the end of their lives is what they do, and a lot of that is about trying to give them the best quality of life and help them live their last days and weeks in as much comfort as possible.
“It’s also about helping them make choices about how they end their lives, because they will all die.
“Our vision is that these facilities have good information available for people about end-of-life care, and voluntary assisted dying should be part of the discussion about all the things that you need to think and consider.”
Related
Urgent action required
Go Gentle rated each provider according to whether it provided clear communication about VAD policies, procedures and information on its website and other resources.
The report said public VAD information should be written with current and prospective residents in mind, including information about:
- What a resident can expect if they ask for VAD information
- How the provider supports residents who wishes to discuss or access VAD services
- If VAD clinicians are not allowed on-site to provide VAD care and assessments, or if VAD medication cannot be stored or administered on-site, what alternatives are available
- The role of staff in providing VAD and contact details for the relevant VAD lead within the facility or organisation
The three largest providers – Opal Healthcare, Bolton Clarke and Estia – were all given a rating of “Urgent action required: Publish comprehensive public VAD information”.
Opal HealthCare, which has the largest share – around 5% – of the total Australian residential aged care market, has no VAD information on its website.
An Opal HealthCare spokesperson told TMR that Opal HealthCare was committed to providing high-quality care, including end-of-life care, which supports and respects the choices and preferences of each resident.
“This includes supporting and facilitating, where required at the residents’ request, their choice to access voluntary assisted dying.”
In what was perhaps a swipe at Go Gentle, but without acknowledging federal legislation, Opal said:
“We recognise that there are some private sector organisations that are demanding greater detail on who chooses voluntary assisted dying.
“Our thorough and compassionate policy and processes comply with all the states and jurisdictions where our care communities are located.
“Voluntary assisted dying is a deeply personal and sensitive matter, and when individuals or families wish to discuss it, we do so through private, one‑to‑one conversations, to ensure appropriate and respectful support.”
Bolton Clarke does not have any information about VAD on its website. Yet its chief operating officer of residential aged care, Glenn Hancock, told TMR:
“Bolton Clarke has comprehensive VAD policies in place and works within state-based legislation to ensure access to VAD information and support for residents and families, in close collaboration with local VAD teams and GPs.”
Dr Swan said:
“That response from someone like Bolton Clarke, who is a large provider who should have sophisticated governance systems in place and should be well aware of the Aged Care Act and their responsibilities – I find that sort of response somewhat disturbing.”
In response, a spokesperson for Bolton Clarke said: “Local teams are the first point of contact for residents requesting information and have a standardised information letter which confirms residents can access VAD in their Bolton Clarke home and includes contact details of the VAD Navigator Service for each state.”
Estia did not respond to Go Gentle’s request for information, but a spokeswoman texted TMR a link to Estia’s palliative care and end-of-life web page that only said:
“We respect each resident’s dignity, values and choices throughout their care, including at end of life. We support the right to seek information about, and where eligible, access Voluntary Assisted Dying.”
The eighth largest provider, Arcare, was also rated as “urgent action required”.
The only information Arcare provides on its website is that they “respect each resident’s right to make informed decisions about their care, including at end of life. Where a resident requests information about Voluntary Assisted Dying”.
“We can assist them to access appropriate information and support, in line with relevant legislation.”
Arcare told TMR that they “remain non-partisan in our approach to VAD.”
“Arcare supports resident choice to engage in a voluntary assisted dying program in accordance with relevant legislation and clinical processes. Where residents or families seek information regarding VAD, appropriate information and support pathways are provided in line with legislative requirements.
Mercy Health was another provider with a rating of “urgent action required”.
Mercy Health said in a statement to TMR that its residential aged care homes “comply with the requirements of VAD legislation in each relevant jurisdiction”.
“Mercy Health does not support VAD and will not provide or participate in VAD.
“Our existing policy and procedures outline how Mercy Health can provide a consistent, ethical and compassionate approach when residents request assistance to end their own life in accordance with this legislation.
“We never abandon those in our care. We never block or impede access to VAD if this is the resident’s choice.”
Mercy’s website says: “We will neither provide nor facilitate voluntary assisted dying as prescribed by Victorian Legislation.
“As a Catholic provider of care we value the dignity of life from conception to death.
“In addition to the many services we provide, there are some that we don’t. Like most care providers in public health and aged care, there are services we are not equipped to provide.
“In addition to those practical limits of care there are two areas where, for moral reasons, we do not provide some services: being women’s health and end-of-life care.”
Best practice providers
Some of the biggest providers rated as “best practice providers” were Regis Aged Care, Bupa Aged Care and Uniting NSW.ACT.
Uniting was used in the report as an example of best practice. A spokesperson said:
“Voluntary assisted dying is legal in all Australian states and the ACT since November 2025 as an end-of-life option for all individuals provided they meet the eligibility criteria set out in the Voluntary Assisted Dying Act 2022 (NSW).
“As such, Uniting NSW.ACT’s focus is on ensuring older people who live in our residential care homes or access our services in other ways have an equal right to access all legal end of life choices.
“Uniting NSW.ACT has a comprehensive 27-page policy and procedure guiding staff and volunteers at our 75 aged care locations and in our home and community care services.
“Central to the document is the primacy of an individual’s choice under the law and that the values and beliefs held by staff, volunteers or others associated with Uniting NSW.ACT’s services must not impede an individual’s right to access lawful treatments or negatively impact an individual’s dignity and right to choose.
“We also provide for staff to be conscientious objectors.”
Regis makes it clear on its website that “Where requested by a resident, access to Voluntary Assisted Dying (VAD) is available for any resident residing in our Homes, in keeping with what the legislation allows.”
Regis chief nursing officer Rameez Hassan said its VAD policy was embedded in its broader framework of person-centred care.
“It’s part of our commitment to dignity, safety and resident/client choice. Our focus is on providing clear, accessible information so residents and clients along with their families and relevant doctors can make informed decisions that are right for them, in line with the legislation in their state/territory,” he said.
“Our role is always to support the resident and client.”
Bupa Aged Care says on its website that “we firmly support every resident’s dignity, choice, and right to explore end-of-life options, including Voluntary Assisted Dying (VAD) in our care homes”.
A Bupa Aged Care spokesperson told TMR that they were “committed to supporting residents to access their end-of-life choices with dignity, compassion and respect”.
“Across our care homes, we work closely with individuals, their families, carers, and voluntary assisted dying navigator services, to support people through their end-of-life journey in the comfort of their home.
“Respecting personal choice, autonomy and dignity is a central part of Bupa’s palliative and end-of-life care framework, helping people navigate one of life’s most personal moments with the upmost care and empathy.”
