Abstract 1875P
Background
In 2017, the Victorian State government passed legislation regarding Voluntary Assisted Dying (VAD). This legislation allows Victorian residents with a progressive, life-limiting illness, to apply to end their life if they meet strict eligibility criteria. Practitioners are required to be accredited, and a standardised registration form for each patient is completed by the coordinating medical practitioner. Over 300 people have applied to this pathway to date, exceeding anticipated projections.
Methods
A retrospective audit of the registration data from the first 50 patients with terminal malignancy seen by the lead author (CM), a qualified VAD assessor in Victoria, Australia, was undertaken. CM is the largest provider to date of VAD assessments. Contemporaneous recording of the reason(s) for requesting VAD was coded into seven categories. Mode of delivery of VAD was either self-administered (oral) or practitioner administered (intravenous).
Results
Between 19th July 2019 and 13th April 2020, 50 cancer patients were assessed by CM. The average age was 69 years (range 34 to 96 years); 29 of the applicants were male (59%). The most common underlying cancer origin was gastrointestinal (n = 18), followed by genitourinary (n = 7), and thoracic (n = 6). Community palliative care services were involved in 48 patients, with a mean duration of involvement of 7.3 months (range 1 to 36 months). The reasons for wanting to access VAD services can be seen in the Table. Table: 1875P
Reported reasons for seeking access to VAD
| Reason | Number of responses |
| Loss of dignity | 47 |
| Less able to engage in activities making life enjoyable | 41 |
| Losing autonomy | 39 |
| Inadequate pain control or concern about it | 30 |
| Losing control of bodily functions | 15 |
| Burden on family, friends/caregivers | 12 |
| Financial implications of treatment | 0 |
| Other | 0 |
VAD medication (oral) was dispensed to 27 patients and taken by 19. Intravenous administration occurred in 5 patients. 18 patients died before completing the application process. No patient withdrew for other reasons.
Conclusions
VAD requests came from a diverse patient population. Almost all patients had engaged with community palliative care services for a significant period of time. A large number of patients died from their cancer prior to accessing VAD. This data should inform planning of VAD services and community discussion around timing of access.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.