Effective in Western Australia from 01 July 2021


  • Voluntary assisted dying (VAD) involves a process to access medication and to enable a person to legally choose the manner and timing of their death. Put simply, VAD means that some adults could ask for medical help to end their life if they have a disease or illness that is so severe it is going to cause their death and they are suffering badly. The term 'voluntary assisted dying' emphasises the voluntary nature of the choice of the person and their enduring capacity to make this decision.
  • Persons who have accessed VAD are able to acquire a 'substance' that they are entitled to carry anywhere at any time as long as they demonstrate decision making capacity. It is considered as part of the individual's possessions.
  • The ingredients or make-up of the 'substance' is not known or disclosed, hence being referred to as such.
  • The 'substance' is secured in a red lock box to make it obvious. It will normally be sealed and locked with a tamper proof tag and combination lock. It cannot be unreasonably withheld from the patient at any time.
  • Health Professionals should be aware of The Act and its requirements

Contact and encounters

Interactions with such persons may occur for a variety of reasons including (but not limited to),

  • Interfacility transfers or discharges etc.
  • Calls for illness or injury requiring assessment or ED admission
  • If a person has taken their 'substance' and someone calls 000

Such encounters are anticipated to be infrequent. Advance Care Directives etc. will normally be in place and communicated.

Clinical Events

Deterioration during transport or transfer should attract care and support to ensure the patient is comfortable. Acquire sound information and agree a plan prior to transport. Use the Interfacility Form as necessary.

No special storage of the 'substance' is necessary. However, good practice must include ensuring it is accounted for and included in handover summaries.

Resuscitation efforts or priority diversion to an Emergency Department should not occur in this patient group.

In the extremely rare event that persons may wish to access and take their 'substance' whilst in St John's care, they should not be actively prevented or discouraged from doing so even if there is a conscientious objection. The person should  be capable of decision making capacity at that time. The Health Practitioner Advice guidance outlines that persons cannot be denied access to the VAD 'substance'. If asked to aid the person, ambulance clinicians;

  • CAN open the secure case when given the code and break the tag if asked
  • CAN uncap the two 'substance' bottles if asked
  • CAN NOT assist the person to mix the contents of the bottles (this differs from other States)
  • CAN NOT assist the person to take the 'substance' . This MUST BE independently undertaken. Unconsciousness will follow within a few minutes of ingestion.

If a person has taken the 'substance' and ended their life, there will normally be a contact person present (e.g. family or friend). These individuals are authorised to secure the 'substance' bottles and paraphernalia for safe disposal as outlined here. In other scenarios, follow the advice of Coronials.


Clinical notes:

Complete your notes in the record as you normally would. Be tactful around how wording around VAD is entered. 

It is reasonable to adopt wording to the effect :

I reasonably believe that the person self-administered, or was administered, a voluntary assisted dying substance in accordance with the Voluntary Assisted Dying Act 2019

This wording might provide additional protections under section 115 of the Act.

Life Extinct Forms:

  • On electronic ROLE forms select the option aligned to 'expected death and/or advanced directive’
  • Avoid annotating any hard copies of life extinct with anything extra than the original form provides (e.g. VAD). 

Legal Protections

There are provisions in the act to protect emergency first responders (e.g. Paramedics and Volunteers) who do not administer lifesaving treatment to a patient who has taken the VAD 'substance' to end their life. Transport Officers are also protected persons. This is reflected in Part 8 Sec 115 of the act.

This is outlined clearly in the Information for First Responders advice by WA Health.


A low threshold to call the Clinical Support Paramedic in SOC should be applied whenever there is any uncertainty or unanticipated event.


Document Control

Clinical Services

Responsible Manager
Head of Clinical Services


Published Date

Review Date

Clinical Resources Website

St John Ambulance Western Australia Ltd (ABN 55 028 468 715) (St John WA) operates ambulance and other pre-hospital clinical services. St John WA’s Clinical Resources, including its Clinical Practice Guidelines (Clinical Resources), are intended for use by credentialed St John WA staff and volunteers when providing clinical care to patients for or on behalf of St John WA, within the St John WA Clinical Governance Framework, and only to the extent of the clinician’s authority to practice.

Other users – Terms of Use

The content of the St John WA Clinical Resources is provided for information purposes only and is not intended to serve as health, medical or treatment advice. Any user of this website agrees to be bound by these Terms of Use in their use of the Clinical Resources.

St John WA does not represent or warrant (whether express, implied, statutory, or otherwise) that the content of the Clinical Resources is accurate, reliable, up-to-date, complete or that the information contained is suitable for your needs or for any particular purpose. You are responsible for assessing whether the information is accurate, reliable, up-to-date, authentic, relevant, or complete and where appropriate, seek independent professional advice.

St John WA expressly prohibits use of these Clinical Resources to guide clinical care of patients by organisations external to St John WA, except where these organisations have been directly engaged by St John WA to provide services. Any use of the Clinical Resources, with St John WA approval, must attribute St John WA as the creator of the Clinical Resources and include the copyright notice and (where reasonably practicable) provide a URL/hyperlink to the St John WA Clinical Resources website. 

No permission or licence is granted to reproduce, make commercial use of, adapt, modify or create derivative works from these Clinical Resources. For permissions beyond the scope of these Terms of Use, including a commercial licence, please contact medservices@stjohnambulance.com.au

Where links are provided to resources on external websites, St John WA:

  • Gives no assurances about the quality, accuracy or relevance of material on any linked site;
  • Accepts no legal responsibility regarding the accuracy and reliability of external material; and
  • Does not endorse any material, associated organisation, product or service on other sites.

Your use of any external website is governed by the terms of that website, including any authorisation, requirement or licence for use of the material on that website.

To the maximum extent permitted by law, St John WA excludes liability (including liability in negligence) for any direct, special, indirect, incidental, consequential, punitive, exemplary or other loss, cost, damage or expense arising out of, or in connection with, use or reliance on the Clinical Resources (including without limitation any interference with or damage to a user’s computer, device, software or data occurring in connection with such use).


Please read this cookie policy carefully before using Clinical Resources from St John WA.

The cookies used on this site are small and completely anonymous pieces of information and are stored on your computer or mobile device. The data that the cookies contain identify your user preferences (such as your preferred text size, scope / skill level preference and Colour Assist mode, among other user settings) so that they can be recalled the next time that you visit a page within Clinical Resources. These cookies are necessary to offer you the best and most efficient possible experience when accessing and navigating through our website and using its features. These cookies do not collect or send analytical information back to St John WA.

Clinical Resources does integrate with Google Analytics and any cookies associated with this service enable us (and third-party services) to collect aggregated data for statistical purposes on how our visitors use this website. These cookies do not contain personal information such as names and email addresses and are used to help us improve your user experience of the website.

If you want to restrict or block the cookies that are set by our website, you can do so through your browser setting. Alternatively, you can visit www.internetcookies.com, which contains comprehensive information on how to do this on a wide variety of browsers and devices. You will find general information about cookies and details on how to delete cookies from your device. If you have any questions about this policy or our use of cookies, please contact us.

St John Ambulance Western Australia Ltd © Copyright 2020, All Rights Reserved

Terms of Use | Privacy Policy | Copyright Statement & Disclaimer