Dr. Cameron McLaren:

Voluntary Assisted Dying Australia and New Zealand is the peak body representing health practitioners involved in the provision of voluntary assisted dying, VAD, in Australia and New Zealand. We represent nearly 150 members involved in the provision of VAD care across all states in Australia, and in New Zealand. Although our members are entitled to advocate for voluntary assisted dying if they choose, the central goal of the organisation is to improve the quality and safety of VAD care provision.

I underwent training in voluntary assisted dying the night before the Act came into effect in the state of Victoria. I was not involved in voluntary assisted dying advocacy prior to this date. The reason I underwent the training was that I had been educated and trained in the paradigm of patient-centred and patient-led care. To me, involvement in voluntary assisted dying was a natural extension of that. I did not want to look after patients for months or years through their battle with cancer, only to refer them on to another provider if they chose to opt for an assisted death. Since beginning my work in this field, the main learning point it has provided me with is that patient-centred care is easy when the patient wants what you want, but it is no less important when the patient chooses a different path.

Overall, the experience of our providers has been that involvement in voluntary assisted dying is fulfilling and rewarding for them and empowering and comforting for the patients who elect to avail of this option. VAD is not seen, nor should it be seen, as an alternative to palliative care. It is seen, and discussed, as an option at the end of a palliative care journey.

Overall, VAD has been a positive change in the Australian and New Zealand healthcare landscapes, but it has not been without its challenges. If introduced in Ireland, I would encourage members to anticipate the need for evolution. This may be interpreted by some as advocating for a "slippery slope", but I firmly believe that the slope does not need to be slippery, simply patient-centred and allowed to evolve as all patient care does over time.

There have been unintended issues with access to voluntary assisted dying for the very people for whom the legislation was intended. Otherwise eligible people have been excluded from eligibility on mere formalities, due to the overbearing nature of some of the legislation in our states and the reluctance to leave many processes to the level of regulations. This has led to issues with access that cannot be resolved without legislative reform. I will now hand over to my colleagues, Dr. Chapman and Dr. Allcroft.