Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Clinician Perspectives on Voluntary Assisted Dying in NSW: Findings from the First 18 Months of Implementation  (146548)

Gemma McErlean 1 , Edwina Light 2 , George Skowronski 2 , Ian Kerridge 2 , Wade Steadman 3 , Mark Arnold 4 , Kerrie Noonan 4 , Stephen Manley 5 , Jessica Davis 5 , Linda Sheahen 2
  1. UTS, POWH and CNSA, Bangor, NSW, Australia
  2. Clinical Ethics Service, South Eastern Sydney Local Health District, Sydney
  3. ICU, NSLHD, Sydney, NSW, Australia
  4. WNSWLHD, Dubbo
  5. NNSWLHD, Ballina

Background: Voluntary assisted dying (VAD) commenced in New South Wales (NSW) in November 2023, creating clinical, ethical and organisational responsibilities for clinicians providing end-of-life care. Cancer was the primary diagnosis for 71.4% of people undergoing VAD assessment in NSW between July 2024 and June 2025, making implementation particularly relevant to cancer services. 

Aim: To examine clinicians’ views and experiences during the first 18 months of VAD implementation in NSW. 

Methods: A cross-sectional survey was conducted across four NSW Local Health Districts. It examined VAD awareness, training, conscientious objection, referral knowledge, VAD-related roles, perceived sources of patient suffering, support use, service impacts and views on law reform. 

Results: Overall, 627 respondents completed the survey; the majority were female (489, 78%), aged >41 years (392, 62.5%), and were nurses (282, 45.2%). Of these, 41.1% worked in haematology/oncology or palliative care. Most supported VAD legalisation (81.3%); 11.0% opposed it and 6.5% were unsure. Conscientious objection was reported by 13.3%, most commonly for religious or faith-based reasons or because VAD was considered inconsistent with values underpinning health care. Among respondents involved in VAD-related care, commonly perceived sources of patient suffering included dependence on others for activities of daily living, uncontrolled pain or other physical symptoms, and a desire to control the circumstances of death. Most respondents perceived no impact on workload, pressure to participate, workplace environment, relationships with patients or usual care. Negative impacts were more frequently perceived in community views of ageing (15.4%) and disability (15.8%) than in direct clinical relationships. 

Conclusion: Early VAD implementation in NSW was broadly supported by clinicians and was generally perceived to have limited impact on clinical work and relationships. Clear referral pathways, education, robust governance and multidisciplinary support are needed to uphold patient choice, meet legal obligations and protect workforce wellbeing across cancer and end-of-life services.