Voluntary Assisted Dying Act 2022

This Act defines and organises a set of interlocking legal and clinical concepts. Each concept carries procedural consequences specified in the text.

• Eligibility: Section 16 sets out the statutory eligibility criteria. The patient must be an adult, satisfy nationality or residency thresholds (s 16(1)(b)-(c)), carry at least one qualifying disease that is advanced, progressive and will cause death within a specified prognosis (s 16(1)(d)(i)-(ii)), be experiencing suffering not tolerable to them (s 16(1)(d)(iii)), have decision-making capacity for voluntary assisted dying (s 16(1)(e)), act voluntarily and not because of pressure or duress (s 16(1)(f)-(g)), and have an enduring request (s 16(1)(h)). The Act expressly excludes eligibility based solely on disability, dementia or certain mental health impairments (s 16(2)).
• Decision-making capacity: Section 6 defines capacity for the Act’s purposes in functional terms: understanding, remembering, appreciating the matters, weighing factors and communicating the decision (s 6(1)). There is a presumption of capacity unless shown otherwise (s 6(2)). Loss of capacity during the process ends eligibility (s 16(3)).
• Pressure or duress: The Act requires that decisions must not be made because of pressure or duress (s 16(1)(g)). The Dictionary (Schedule 1) contains the defined term (referred to in s 4 and elsewhere). Practitioners must ask about pressure from beneficiaries (e.g., s 30(4)(n), 41(4)(n)) and follow Health Secretary guidelines for assessing pressure or duress (s 181(2)(c)).
• Coordinating, consulting and administering practitioners: The Act creates distinct practitioner roles with eligibility requirements (coordinating/consulting in s 18; administering in s 55) and separate duties at each step (e.g., coordinating practitioner conducts first assessment s 25; consulting practitioner must independently assess s 36; administering practitioner implements practitioner administration s 60).
• Request and assessment process: A statutory procedural ladder: first request (s 19), first assessment (ss 25-30), consulting assessment (ss 31-41), written declaration (ss 43-47), final request and final review (ss 48-52), and then administration decision and supply (Pt 4 Div 2).
• Voluntary assisted dying substance and authority: Health Secretary approves substances (s 7) and the Board grants a voluntary assisted dying substance authority after considering required documents (ss 70-72). Only authorised suppliers may prepare and supply substances (s 59(4), 60(4)).
• Forms, records and notification regime: Numerous "approved forms" are mandated and must be given to the Board within stated timeframes: first request form (s 23), first assessment report (s 30), consultation referral (s 34), consulting assessment report (s 41), written declaration (s 47), final request form (s 51), final review form (s 52), administration decision form (s 57), prescription form (s 61), practitioner administration form (s 62), authorised supply and disposal forms (ss 78, 81), and practitioner transfer forms (ss 64, 175). Failure to give specified forms attracts maximum penalties, often 100 penalty units (see e.g., ss 30(2), 34(1), 41(2), 47, 51(1), 52(4), 57(6), 61(1), 78(3), 81(3), 83(3), 171).
• Institutional participation and access obligations: Entities (residential facilities and health entities) may refuse to provide voluntary assisted dying services (s 89(1)-(2)), but if they do not provide services they must not hinder access to information and must allow or facilitate practitioner attendance or patient transfer in many circumstances (ss 90-106). Entities that decline must publish non-availability notices (ss 98, 107).
• Oversight, data and reporting: The Board is tasked with monitoring the Act, maintaining lists of willing practitioners (s 136(1)(a)-(b)), collecting and keeping specified statistical information (s 170), preparing an annual report (s 173) and potentially referring matters to other agencies (s 136(1)(f)). The Health Secretary must issue an access standard addressing how access will be facilitated, with particular attention to regional residents (s 174).
• Legal review: Part 6 empowers eligible applicants to seek a new hearing in the Supreme Court to review certain practitioner decisions and Board refusals (s 109). A review suspends ongoing processes (s 111); the Court may substitute its decision and that substitution can have specified legal effects (ss 113-115).

Each concept is connected to specific duties, forms, timeframes and compliance obligations that shape the incentives of practitioners, institutions and the Board. For example, the multiple independent assessments, written declaration with witness rules (ss 43-45) and Board authorisation (ss 70-72) create sequential gates intended to test capacity, voluntariness and compliance with the Act’s standards.

The Act names and prescribes roles for specific actors. It also creates consequential obligations for related bodies.

• Patients and their agents: Any adult seeking voluntary assisted dying is directly affected by the eligibility criteria (s 16) and the procedural requirements (Pt 3 and Pt 4). Patients must make a first request, may withdraw at any time (s 20), must make a written declaration witnessed according to specific rules (ss 43-45) and make an administration decision (ss 57-58). A patient who chooses self-administration must appoint a contact person (ss 57(3)(a), 66-68).
• Medical practitioners: Practitioners operate as coordinating, consulting or administering practitioners and must meet eligibility requirements (s 18 for coordinating/consulting; s 55 for administering). Practitioners decide to accept or refuse requests or referrals (ss 21, 32) but must record decisions and notify the Board within prescribed timeframes (e.g., ss 22, 23, 34). Practitioners are subject to professional-conduct consequences: the Act notes contraventions may constitute unsatisfactory professional conduct or misconduct under the Health Practitioner Regulation National Law (s 11; s 10 Note; s 131(3)).
• Contact persons and agents: For self-administration the contact person has a statutory role and must consent, comply with guidelines (s 67(1)(e)(i)-(ii)), may refuse to continue (s 69) and bears duties to handle unused substances and to inform the coordinating practitioner of death (ss 68(2), 125). Agents may collect and deliver substances on a patient’s behalf in limited authorised ways (s 59(7)).
• Authorised suppliers and authorised disposers: The Health Secretary may authorise classes of registered health practitioners to supply or dispose of prescribed substances (s 84). Such persons are required to authenticate prescriptions (s 75), give required written information at supply (s 76), attach statements to packaging (s 77) and submit supply and disposal forms to the Board within 5 business days (ss 78(3), 81(3)). Failure to comply attracts penalties (various provisions impose 100 penalty units).
• Health care establishments and residential facilities and their owners: These entities may choose not to provide voluntary assisted dying services (s 89(1)-(2)). Where they decline, they retain obligations not to hinder access to information and, in many circumstances, must permit practitioner attendance, or facilitate transfer to a place where assessments or administration may occur (ss 90-107). Entities that decline must publish their non-availability status (ss 98, 107).
• The Voluntary Assisted Dying Board: Created by s 134 and given monitoring, gatekeeping and reporting functions (s 136). The Board keeps lists of willing practitioners (s 136(1)(b)) and grants substance authorities (ss 71-72). The Board holds records and must keep a register of authorised suppliers and disposers (s 84(6)).
• The Health Secretary and Minister: The Health Secretary approves substances (s 7), issues the access standard (s 174), issues guidelines and approves training and resources (ss 180-181, 182). The Minister may give written directions to the Board (s 141) and can require the Board to disclose specified information (s 142). The Minister is also responsible for periodic statutory reviews of the Act’s operation (s 186).
• Courts and regulators: The Supreme Court is given a central review role (Part 6) for disputes about residency, capacity, voluntariness and pressure or duress (s 109). Other bodies will be engaged through referrals by the Board (s 136(1)(f)), and the Act cross-references the Health Practitioner Regulation National Law with respect to professional conduct (s 11).

Who pays and costs are not directly itemised in the Act text. The Act creates administrative reporting burdens and forms which impose time and record-keeping obligations on practitioners, authorised suppliers and the Board (numerous sections requiring forms to be lodged within 5 business days, e.g., ss 23, 30, 34, 41, 47, 51, 52, 57, 61, 78, 81, 83). Those are compliance costs borne by practitioners, entities operating facilities, suppliers/disposers and the Board. The Health Secretary must provide staff and facilities to support the Board (s 139), indicating a public administrative cost. The Act also contemplates facilitation of transfers and practitioner attendance at facilities; those practical steps are operational burdens falling on entities that do not provide services but must facilitate access in certain circumstances (ss 92-106).

Finally, the Act affects information flows: practitioners, the Board and the Health Secretary will hold and use sensitive personal and medical information, with strict prohibitions on unauthorised recording, disclosure or publication (s 126, s 127). The Board is required to collect and report specified statistical information (s 170) and to prepare an annual report (s 173).

The Act sets out the legal duties of practitioners, entities and the Board, and the statutory rights of patients and other persons. Below are the principal duties and rights expressed in the text, with section references.

Duties on medical practitioners

• Decide to accept or refuse first requests and referrals and notify patients within specified timeframes (s 21(1)-(4); s 32(1)-(4)). The reasons for refusal are limited by the Act (s 21(2); s 32(2)).
• Record the first request and decision in the medical record (s 22).
• If accepting a first request, act as the coordinating practitioner (s 24).
• Conduct a first assessment and decide on each eligibility criterion (s 25(1)-(2)); refer to other medical practitioners or psychiatrists where unable to decide (ss 26-27).
• Provide specified information to patients assessed as meeting the eligibility criteria, including diagnosis, prognosis, treatment and palliative options, risks, and the requirement for a written declaration and witnesses (s 28(1)). The practitioner must take reasonable steps to fully explain clinical guidelines and a plan for administration (s 28(4)).
• Complete and submit required forms to the Board within prescribed timeframes (numerous sections, e.g., s 23, s 30(2), s 34(1), s 41(2), s 47).
• Prescribe a voluntary assisted dying substance only subject to a Board authority (s 59(3), s 60(3)) and comply with the detailed prescription and supply rules (s 74-76).
• For administering practitioners, certify in an approved practitioner administration form after administration with specific details (s 62), and supply the Board with the form within 5 business days (s 62(4)).

Duties and powers of the Board and Health Secretary

• Board: monitor operation, keep lists of willing practitioners, decide residency exemption applications (s 17(1)-(2); s 136(1)(b), (c)), grant/refuse voluntary assisted dying substance authorities, maintain registers of authorised suppliers/disposers (ss 71-72; s 84(6)), collect and use information, and report annually (ss 136, 170, 173). The Board must notify receipt of forms (s 171) and notify the Health Secretary of disposal forms (s 171(2)).
• Health Secretary: approve voluntary assisted dying substances (s 7), issue access standard (s 174), approve forms and training and guidance (ss 180-182, 182), issue guidelines on referrals and assessment of pressure or duress (s 181), and publish the access standard (s 174(5)).

Rights and protections for practitioners and others

• Conscientious objection: registered health practitioners have the right to refuse participation if they have a conscientious objection (s 9(1)); subsection (2) and (3) make clear the exemption is not limited.
• Liability protection: persons acting in good faith and with reasonable care in accordance with the Act or believing on reasonable grounds they are acting in accordance with the Act do not incur civil or criminal liability and their actions are not to be treated as breaches of professional ethics or grounds for professional misconduct (s 131).
• Specific protection for medical practitioners referring patients or requesting records under the Act (s 132): such acts are permitted despite other laws and do not attract sanction by professional regulators solely because of making the referral or request.
• Protection for persons assisting or present (s 130): those present at an administration in accordance with the Act or assisting in good faith do not incur criminal liability.
• Protection for emergency responders and health practitioners not to administer lifesaving treatment when they reasonably believe the person is dying after lawful self- or practitioner-administration (s 133).

Patient rights and safeguards

• Right to decide not to proceed at any time (s 20(1); s 54).
• Right to be informed about treatment options, palliative care, outcomes and risks (s 4(1)(c), s 28(1)).
• Right to withdraw an administration decision at any time; revocation must be recorded and notified (s 58).
• Right that a death in accordance with this Act not be considered suicide for State law purposes (s 12(1)).
• Right to an independent judicial review in the Supreme Court for certain practitioner or Board decisions (s 109); the review is a new hearing (s 109(2)) and suspends the process while pending (s 111).

Institutional duties and limits

• Residential facilities and health entities may refuse to provide services relating to voluntary assisted dying (s 89(1)-(2)), but if they do not provide such services they must facilitate access to information and allow reasonable practitioner attendance or patient transfer when requested (ss 90-107). If an entity declines to provide services it must publish the non-availability information (ss 98, 107).

Record-keeping and notification duties

• Many mandatory forms must be completed and sent to the Board or Health Secretary within 5 business days at various steps (e.g., ss 23, 30(2), 34(1), 41(2), 47, 51(1), 52(4), 57(6), 61(1), 78(3), 81(3), 83(3)). The Board must notify receipt (s 171).

Offences and penalties create duties

• False or misleading statements in connection with any purpose or requirement under the Act are an offence under the Crimes Act, Part 5A (s 123) and hence subject to criminal sanctions.
• Unauthorised recording, use or disclosure of information obtained under the Act is an offence with a maximum penalty of imprisonment for 12 months (s 126(1)), save for express statutory exceptions (s 126(2)).
• Improper publication of personal information concerning a Part 6 proceeding is an offence with a maximum 12 months imprisonment (s 127).

These duties and rights structure the behaviour of clinicians, institutions, the Board and the Health Secretary: clinicians are gatekeepers and record-keepers with specific timing duties; institutions may refuse participation but must facilitate access; the Board and Health Secretary set standards and collect data; patients retain the right to change their mind at any time. Compliance is enforced both by professional-regulatory consequences (cross-referencing the National Law) and by statutory penalties and criminal offence provisions in Part 7.

The Act establishes a mixed enforcement regime combining administrative oversight, statutory offences and professional accountability pathways. Enforcement mechanisms and sanctions are spread across the Act and linked to specific procedural requirements.

Administrative enforcement and reporting

• The Board is the central administrative monitor and gatekeeper. It receives and records required forms, maintains registers of authorised suppliers and disposers (s 84(6)), and must notify receipt of forms (s 171). The Board also has powers to refer matters to other agencies including police, the Registrar of Births, Deaths and Marriages, the State Coroner and professional regulators (s 136(1)(f)). The Board grants or refuses voluntary assisted dying substance authorities (ss 71-72) and must refuse a substance authority if required documents are missing or it suspects non-compliance (s 72(1)). When refusing, the Board must notify the coordinating practitioner within 2 business days with reasons (s 72(2)).
• The Health Secretary oversees standards (s 174), guidelines (s 181), forms (s 182) and authorisation of substances (s 7). The Health Secretary may audit and instruct the Board (ss 141-142).

Criminal offences and imprisonment

• False or misleading information: The Act makes it an offence under the Crimes Act 1900, Part 5A for a person to make statements known to be false or misleading or omit information that renders a statement misleading for any purpose under this Act (s 123). The Act references the Crimes Act category but does not state a separate maximum penalty within this text.
• Specific criminal penalties with imprisonment:
  • Cancellation reporting: An authorised supplier who cancels a document presented as a prescription must notify the Health Secretary and may face imprisonment for 12 months where the supplier is satisfied the document does not comply or is false (s 124(2), maximum penalty imprisonment 12 months).
  • Contact person obligations: Failure by a contact person to deliver unused substance to an authorised disposer within 14 days after revocation or death attracts a maximum penalty of imprisonment for 12 months (s 125(1)-(2)). The contact person has explicit statutory duties and possible imprisonment for non-compliance.
  • Unauthorised recording, use or disclosure of information obtained because of a function under the Act: maximum penalty imprisonment for 12 months (s 126(1)). Statutory exceptions include use for Act functions or court proceedings (s 126(2)).
  • Publication of personal information about a Part 6 proceeding: maximum penalty imprisonment for 12 months (s 127(1)).

Monetary penalties and administrative fines

• Many obligations to complete and give forms to the Board carry a maximum penalty of 100 penalty units where specified (for example: s 30(2) first assessment report, s 34(1) consultation referral form, s 41(2) consulting assessment report form, s 47 written declaration to Board, s 51(1) final request form, s 52(4) final review form, s 57(6) administration decision form, s 61(1) prescription form, s 78(3) authorised supply form, s 81(3) authorised disposal form, s 83(3) practitioner disposal form). The Act does not set the monetary value of a penalty unit here but consistent statutory practice in NSW means it is a non-negligible financial sanction. These penalties are typically framed as "maximum penalty,100 penalty units", signalling civil or regulatory enforcement.

Professional discipline and regulatory overlap

• The Act expressly states that contraventions by registered health practitioners may constitute unsatisfactory professional conduct or professional misconduct under the Health Practitioner Regulation National Law (s 11). The Act also states that withdrawal of usual services by a treating practitioner because of a patient’s request is unlawful and may be unsatisfactory professional conduct (s 28(1)(k)(ii)-(3)). Sections 10 and 28 contain notes that a contravention may be professional misconduct under the National Law, indicating professional regulators are an enforcement channel.
• Section 132 provides protections to medical practitioners who refer or request records under the Act, insulating them from punishment under other laws and from professional sanction for making referrals or requests.

Poisons Act enforcement linkage

• The Act makes Part 5, Divisions 2-4 of the Poisons and Therapeutic Goods Act 1966 (referred to as the “applied provisions”) apply for enforcement of this Act, with necessary modifications (s 128). Section 14 asserts that when inconsistency exists between this Act and the Poisons and Therapeutic Goods Act 1966 or the Drug Misuse and Trafficking Act 1985, this Act prevails to the extent of the inconsistency. Practically, enforcement mechanisms and offences relating to poison handling and supply are therefore brought into the enforcement architecture for the voluntary assisted dying substances, with regulatory adaptations.

Judicial review and suspension

• Part 6 allows eligible applicants to apply to the Supreme Court for a review of certain practitioner decisions and Board refusals (s 109). Where a review application is made, the Act suspends the request and assessment process (s 111(2)) or if the process had been completed, suspends Part 4 steps including prescription, supply and administration (s 111(3)). These suspension effects are self-executing statutory enforcement mechanisms that pause further actions until the Court decides or disposes of the application. The Supreme Court may substitute its decision for the reviewed decision (s 114) or may find that the patient is ineligible (s 115). The Court’s hearings are to be held in private (s 117), with protections on publication of personal information (s 121).

Referral and cross-agency enforcement

• The Board may refer matters it identifies to police, coroners, registrars and professional regulators (s 136(1)(f)). The Act requires the registrar of a convicting court to notify the Health Secretary and the Board of convictions under the Act (s 129).

Other enforcement features

• The Act also contains specific prohibitions (e.g., no structured administration and supply arrangements, s 86), and a framework for authorising suppliers and disposers by Gazette notice (s 84) with registration and public inspection restrictions (s 84(6)-(7)). The register is only inspectable by a limited class of persons (s 84(7)).

In sum, enforcement mixes criminal penalties for certain misuses and unauthorised disclosures, substantial monetary penalties for record and notification breaches, professional regulatory exposure for practitioners, administrative monitoring and Board gatekeeping, and judicial review with suspension of processes. The Act also imports enforcement tools from the Poisons and Therapeutic Goods Act for handling and disposal offences.

The Act is interleaved with a number of existing statutory regimes. The text itself contains explicit primacy clauses, cross-references and carve-outs that determine legal interaction.

Primacy and inconsistencies

• The Act contains an express inconsistency rule: if there is an inconsistency between a provision of this Act and a provision of the Poisons and Therapeutic Goods Act 1966 or the Drug Misuse and Trafficking Act 1985, this Act prevails to the extent of the inconsistency (s 14). This creates a limited legal primacy for voluntary assisted dying supply, possession and disposal rules over those Acts where they conflict.

Application of Poisons Act enforcement provisions

• The Poisons and Therapeutic Goods Act 1966 Part 5 Divisions 2-4 are made applicable for enforcement of this Act, with prescribed and other necessary modifications (s 128(1)). The Act also states a definition in that Poisons Act of a term used in the applied provisions applies for the purposes of s 128(2). This imports much of the Poisons Act’s enforcement machinery into the regulatory architecture for voluntary assisted dying substances, albeit with modifications and where consistent with this Act.

Health Practitioner Regulation National Law and professional regulation

• Multiple sections acknowledge overlap with professional disciplinary regimes. Contraventions of the Act by registered health practitioners may constitute unsatisfactory professional conduct or professional misconduct under the Health Practitioner Regulation National Law (s 11). The Act protects practitioners who refer or request information under the Act from punishment under other laws or censure by professional regulators for making the referral or request (s 132). Section 131(3) states that acts done in good faith and with reasonable care under the Act are not to be regarded as a contravention of professional ethics or a ground for unsatisfactory professional conduct.

Crimes Act and criminal law

• The Act references the Crimes Act for false and misleading statements (s 123) and specifically references s 41C of the Crimes Act in relation to the offence of applying pressure or duress (see s 28(1)(j) Note, and elsewhere). The Act excludes voluntary assisted dying action from constituting suicide for State law purposes (s 12(1)) and clarifies that voluntary assisted dying action does not provide a basis for police action under the Mental Health Act provision that otherwise treats attempts to cause serious physical harm (s 12(2)). These cross-references shape how criminal law and mental health law apply in the VAD context.

Coroners, births and deaths registration and police

• The Act requires medical practitioners giving cause-of-death certificates to identify when they know or reasonably believe the person accessed voluntary assisted dying under the Act and to record the qualifying disease (s 87(4)-(6)). The Board may refer matters relevant to voluntary assisted dying to the Commissioner of Police, the Registrar of Births, Deaths and Marriages, the State Coroner, and other bodies (s 136(1)(f)).

Guardianship and powers of attorney

• The Act expressly provides that voluntary assisted dying is not a matter to which the Guardianship Act 1987 or the Powers of Attorney Act 2003 apply, nor may provision be made under instruments under those Acts for voluntary assisted dying (s 184). This removes adult substitute decision-making instruments under those Acts from operating to authorise voluntary assisted dying.

Other statutory reporting and administrative obligations

• The Act requires the Health Secretary to include palliative care spending and activity data in the Ministry’s annual report framework (s 185), thereby integrating the VAD regime’s oversight into public health reporting.

Privacy and information law

• The Act contains strict prohibitions on recording, use or disclosure of information obtained by reason of a function under this Act (s 126) with statutory exceptions (s 126(2)). The Board may disclose non-personal information to public authorities or persons for education or research (s 169), and the Board must keep and publish statistical information as required by s 170, but the Act limits the Board’s annual report from including personal information (s 173(3)(a)).

Administrative law and the Minister’s powers

• The Minister may give directions to the Board about performance of its functions (s 141) but cannot direct the Board about performance in relation to a particular person or matter (s 141(3)). The Minister can also compel disclosure of information from the Board (s 142) subject to personal-information limits (s 142(2)).

Interpreters and accreditation

• The Act cross-references interpreter accreditation and limits interpreter eligibility (s 183). The Health Secretary, by Gazette notice, may approve accredited bodies (s 183(1)(a)).

Courts and judicial secrecy

• The Supreme Court’s review proceedings are to be held in private (s 117). Publication of personal information connected with Part 6 proceedings is forbidden (s 127), and the Court must ensure published decisions exclude personal information (s 121).

In practical terms, the Act both imports existing regulatory frameworks (Poisons Act for handling of substances, Health Practitioner Regulation National Law for professional regulation) and creates carve-outs (s 14 primacy, s 184 Guardianship and Powers of Attorney exclusions). It also creates pathways for inter-agency cooperation via the Board’s referral powers (s 136(1)(f)). The Act’s cross-references shape the legal landscape for practitioners, the Board, hospitals and registrars, and limit the application of substitute decision-making laws to voluntaries assisted dying.

The Act text contains limited internal amendment signals and a commencement clause, and notes at least one schedule entry showing amendment and repeal history of a schedule item.

• Commencement: The Act does not commence immediately but comes into operation on the day that is 18 months after assent (s 2). That delayed commencement creates a defined implementation window for regulators to prepare standards, guidance, training and administrative structures (Health Secretary and Board duties in Pt 10 and Pt 11).
• Schedule and repeal note: The included Schedule 1A is marked as "Repealed" and includes an amendment note: "sch 1A: Am 2023 No 7, Sch 2.50. Rep 1987 No 15, sec 30C." This shows that at least part of the instrument’s schedules has already been the subject of amendment and repeal action recorded in the text. No other specific amendment chronology or dates are supplied within the provided text.
• Ongoing review requirement: The Act mandates statutory reviews of its operation. The Minister must review the operation and effectiveness of the Act and prepare a report as soon as practicable after the second anniversary of the day on which s 186 comes into operation and thereafter at intervals not exceeding five years (s 186(1)). The review must consider the principles in s 4, with particular attention to access for regional residents (s 186(2)). The report must be laid before each House of Parliament within a specified period (s 186(3)). These statutory reviews create recurring opportunities for formal amendment recommendations to Parliament.
• Regulations and delegated instruments: Section 187 empowers the Governor to make regulations prescribing matters required or permitted under the Act or necessary or convenient for its operation. The Act also delegates various administrative details to the Health Secretary by Gazette notice,approvals of substances (s 7), authorising suppliers/disposers (s 84), designation of authorised officials for public information (s 178(4)), approval of an official voluntary assisted dying care navigator service (s 179(1)) and the Health Secretary’s power to approve forms (s 182). These powers identify the primary vehicles for non-legislative change and operational amendment via statutory instruments and Gazette notices.
• Board delegations and internal governance: The Board may delegate many functions to members or committees (s 138) and the Minister can give written directions to the Board (s 141). These mechanisms allow internal operational changes without primary-legislation amendment.

The Act itself does not list a wider amendment history beyond the Schedule note. The statutory review mandating reports (s 186) will serve as the formal parliamentary mechanism to propose legislative changes at two years and thereafter every five years, which is the embedded legislative amendment pathway.

The Act sets up a specific statutory route for judicial scrutiny rather than providing a catalogue of prior litigation. The text does not name any cases or record prior judicial decisions under the Act. Instead, it prescribes the litigation mechanism and protections that will govern future disputes.

• Statutory review route: Part 6 (ss 108-122) creates a de novo review procedure before the Supreme Court for eligible applicants to challenge certain practitioner decisions and Board refusals. Section 109(1) lists the decisions that may be reviewed: practitioner decisions under first or consulting assessments concerning ordinary residence (12-month requirement), decision-making capacity for voluntary assisted dying, whether the patient is acting voluntarily, and whether the patient is acting because of pressure or duress; decisions in final review forms by a coordinating practitioner on capacity or voluntariness; and decisions of the Board to refuse a voluntary assisted dying substance authority (s 109(1)(a)-(d)). Section 109(2) confirms that a review is to be dealt with as a new hearing where additional evidence is permitted.
• Procedural consequences on review: Section 111 suspends the request and assessment process or Part 4 access steps while a review application is on foot. Section 112 automatically withdraws a review application if the patient dies. The Supreme Court’s powers to decide are enumerated in s 113, and s 114-115 set out the legal consequences of the Court’s determinations, including when the Court substitutes its decision for the reviewed decision and when the outcome is to render the patient ineligible.
• Private and confidential hearings: Hearings are to be in private (s 117). The Principal Registrar must give notice of an application to coordinating/consulting practitioners, administering practitioners where relevant, the Health Secretary and the Board (s 118). The Court must give written reasons and provide those to parties and relevant officials (s 120), and protect personal information when publishing reasons or decisions (s 121). There are criminal prohibitions against publishing personal information about Part 6 proceedings (s 127).
• Procedural participation duties: Practitioners must supply statements of reasons and relevant documents to the Court when a review application is made (s 119), within seven business days or a shorter period ordered by the Court (s 119(2)).
• No cases named: The Act text does not cite or name any judicial decisions or precedent; therefore the Act itself contains no litigation history. The statutory litigation pathway (Part 6) is the instrument’s explicit method for resolving the enumerated disputes; actual litigation history will be created after commencement and through cases brought under s 109.

Because the Act provides a full and public procedure for judicial review of certain decisions, the Supreme Court is anticipated to be the primary forum where contested determinations (residency, capacity, voluntariness, pressure or duress, Board refusals) will be litigated. The Act mandates private hearings and restrictions on publication of personal information in those proceedings (ss 117, 121, 127), and gives the Court power to make interim orders on a review application (s 122).

In short: the Act contains no pre-existing litigation record. Instead it establishes a defined judicial pathway, procedural rules and confidentiality protections that will govern future litigation under the statute.

The Act contains a number of technical, procedural and practical pitfalls that practitioners, institutions and patients should note. These are not interpretations but direct implications drawn from the statutory wording. Each item cites the controlling provision.

• Strict form and timing obligations with penalties. Many steps require submission of approved forms to the Board within 5 business days and carry specified maximum penalties (commonly 100 penalty units). Examples include the first assessment report form (s 30(2)), consulting assessment report form (s 41(2)), written declaration (s 47), final request form (s 51(1)), final review form (s 52(4)), administration decision form (s 57(6)), prescription form (s 61(1)), authorised supply and disposal forms (ss 78(3), 81(3)), and practitioner disposal form (s 83(3)). Failure to comply attracts statutory maximum penalties. Practitioners must build administrative capacity to meet these timelines.
• Witness eligibility rules for written declarations and witnessing administrations. The written declaration requires two witnesses and specifies ineligible witnesses (s 44). Section 45 requires witnesses to certify the voluntariness of the patient and that they are not ineligible witnesses. For practitioner administration witness eligibility excludes family members or employees of the administering practitioner (s 63(2)). These rules are detailed and can invalidate or complicate downstream steps if not followed cautiously.
• Contact person mandatory for self-administration and duties thereof. A patient who chooses self-administration must appoint a contact person (s 15(g), s 57(3)(a), s 66). The contact person has legal responsibilities: they are authorised to receive and handle the substance (s 68(1)), must inform the coordinating practitioner if the patient dies (s 68(2)), and if unused substances remain after revocation or death they must give them to an authorised disposer within 14 days or face imprisonment up to 12 months (s 125(1)-(2)). Failing to secure an eligible and willing contact person can delay or prevent self-administration.
• Storage requirement: locked steel box. Any person who receives a voluntary assisted dying substance must store it in a locked box made of steel and not easily penetrable and locked with a sturdy lock (s 79). This is a specific physical-security standard, and the authorised supplier must inform the recipient about storage requirements (s 76(2)(b)). Non-compliance risks statutory offences via related poison handling enforcement provisions (s 128).
• Institutions may refuse services but must facilitate access in certain situations. Residential facilities and health entities may decline to provide VAD services (s 89(1)-(2)), but if they do they must not hinder access to information and must allow reasonable access to a practitioner or facilitate transfers depending on whether the person is a permanent resident and the circumstances (ss 90-107). The practical effect is a tension between institutional non-participation rights and statutory duties to facilitate access,coordination and clear policies within facilities are necessary to manage requests and transfers lawfully.
• Prohibition on initiating discussion by health care workers except in narrowly defined circumstances. Health care workers who provide services must not initiate a discussion about voluntary assisted dying or suggest it, subject to limited exceptions for medical practitioners who must also inform patients about standard treatments and palliative options (s 10(1)-(3)). This is a conduct restriction that interacts with informed consent and clinical communication norms; failing to comply may expose practitioners to professional conduct proceedings (s 10 Note, s 11).
• Board gatekeeping and potential for refusal. The Board may refuse to issue a voluntary assisted dying substance authority if required documents are missing or if it suspects statutory requirements have not been met (s 72(1)), and it must give written notice with reasons within 2 business days (s 72(2)). Coordinating practitioners must plan for this gatekeeper step before prescribing (s 59(3), s 60(3), s 71).
• Judicial suspension of the process on review. If an eligible applicant applies to the Supreme Court under s 109, s 111 suspends the request and assessment process or access steps under Part 4 while the review is pending. Practitioners must be alert to potential review applications and the automatic suspension effect, which may disrupt time-sensitive clinical plans.
• Confidentiality and publication prohibitions. The Act creates strict prohibitions on recording, using or disclosing information obtained under the Act (s 126), with limited statutory exceptions. Part 6 proceedings are private (s 117), and publication of personal information concerning such proceedings is a criminal offence (s 127). Practitioners, media and institutions must take care in handling information and communications.
• Interaction with guardianship and enduring instruments: excluded. The Act expressly removes voluntary assisted dying from the scope of the Guardianship Act 1987 and Powers of Attorney Act 2003 (s 184). This can be a trap for practitioners relying on enduring instruments or attorneys to assent to VAD decisions: such instruments do not authorise VAD under this Act.
• Prescription and supply constraints. The prescription must clearly indicate it is for a voluntary assisted dying substance, certify completion of the process, state the administration decision type, include the patient’s telephone number and not be in the form of a medication chart or provide for repeat supply (s 74). The coordinating practitioner must give the prescription directly to an authorised supplier (s 74(5)). Authorised suppliers must authenticate the prescription and identity (s 75) and submit authorised supply forms (s 78). These are tight administrative controls which, if breached, can create cancelled prescriptions and criminal exposure for suppliers (s 124).
• Prohibition on structured administration and supply arrangements. The Act forbids issuing a document that sets out circumstances in which a class of health professionals may administer or supply a medicine for VAD (s 86). Employers or institutions used to standing orders or NP supply pathways need to be aware this is disallowed.
• Palliative-care reporting obligation. The Health Secretary must include detailed palliative-care expenditure and service provision data in the Ministry’s annual report (s 185). Agencies and hospitals may therefore be required to supply data for public reporting.
• Definitions and prognosis thresholds. Section 16(d)(ii) differentiates prognosis timelines: 12 months for neurodegenerative disease or 6 months otherwise. Practitioners must assess prognosis on the balance of probabilities and may need specialist input (s 26, s 37). These prognostic thresholds are statutory gates and liable to disagreement.
• Eligibility exclusions for certain conditions. A person is not eligible merely because of a disability, dementia or certain mental health impairments (s 16(2)), and the Act expressly warns that dementia alone does not suffi ce to meet eligibility (s 16(1)(d) Note). Assessors must therefore ensure the qualifying disease and prognosis are explicitly satisfied.

Each of these technical requirements is a compliance hinge where administrative error, delayed notification, unsuitable witnesses, missing authorisations, or miscommunication can create legal exposure, process suspension, or denial of access. Practitioners and institutions should map workflows to the statutory steps and time limits and to the Board/Health Secretary's guidance and forms.

This section sets out a practical, source-grounded checklist-style pathway to comply with the Act’s principal steps and associated statutory requirements. Citations are provided to the controlling provisions. This is procedural guidance based on the Act’s text; it does not substitute for legal or clinical advice.

1. Understand eligibility up front (s 16)

   • Confirm the person is an adult and meets citizenship or residency conditions (s 16(1)(a)-(c)). If the 12-month ordinary-residence requirement might not be met, consider applying for a residency exemption under s 17 with the Board and gather evidence of a substantial connection or compassionate grounds (s 17(1)-(2)).
   • Verify the patient has a qualifying disease, illness or medical condition: advanced, progressive and expected to cause death within the statutory timeframes (s 16(1)(d)(i)-(ii)) and that the suffering is not tolerable to the patient (s 16(1)(d)(iii)).
   • Assess decision-making capacity for VAD per the Act’s functional test (s 6). Keep in mind the presumption of capacity unless proven otherwise (s 6(2)). If decision-making capacity is in doubt, plan referrals under s 27/38.
   • Ensure voluntariness and absence of pressure or duress (s 16(1)(f)-(g)); follow Health Secretary guidelines on pressure/duress (s 181(2)(c)).

2. First request and coordinating practitioner role (ss 19-25)

   • The patient must make a first request during a medical consultation, clear and unambiguous, in person if practicable (s 19(1)-(3)). If in-person is not practicable, audiovisual is allowed under s 176(1).
   • The recipient medical practitioner must decide to accept or refuse within statute limits and notify the patient within 2 business days unless conscientious objection requires immediate refusal notice (s 21(1)-(4)).
   • Record the first request and decision in the medical record (s 22).
   • Complete the first request form and provide a copy to the Board within 5 business days (s 23(1)-(2)). Coordinate administrative workflows to meet the 5-business-day deadline.

3. First assessment by coordinating practitioner (ss 25-30)

   • If the practitioner accepts, they become the coordinating practitioner (s 24). The coordinating practitioner must assess eligibility and decide on each criterion (s 25(1)-(2)).
   • If uncertain about diagnosis/prognosis, refer to appropriate specialist under s 26 and adopt the specialist’s report where suitable (s 26(2)-(4)). If unsure about capacity, voluntariness or pressure/duress, refer to a psychiatrist or other appropriate person per s 27.
   • If assessed as meeting eligibility criteria, inform the patient in writing and explain diagnosis, treatment, palliative options, potential risks of VAD substances, and other information mandated by s 28(1). Take reasonable steps to fully explain clinical guidelines and an administration plan (s 28(4)).
   • Complete the first assessment report form and give it to the Board within 5 business days; give a copy to the patient as soon as practicable (s 30(2)-(3)). Note the maximum penalty attached (s 30(2)).

4. Consulting assessment and independent check (ss 31-41)

   • Refer the patient to a consulting practitioner for an independent assessment if the first assessment found eligibility (s 31).
   • The consulting practitioner must independently assess all eligibility criteria and make an independent decision (s 36(1)-(2)). If unsure, make referrals under ss 37-38.
   • The consulting practitioner must inform patient and coordinating practitioner of the outcome and complete the consulting assessment report form and provide it to the Board within 5 business days (s 41(1)-(3)).

5. Written declaration (ss 43-47)

   • A patient assessed as eligible by both coordinating and consulting practitioners may make an approved-form written declaration (s 43(1)-(2)).
   • Ensure the declaration states voluntariness, absence of pressure or duress, and understanding of effect (s 43(3)(a)). If the patient cannot sign, follow substituted-signature rules (s 43(4)-(5)) and ensure certification by the interpreter where relevant (s 43(6)).
   • Use two eligible witnesses (s 44). Avoid ineligible witnesses (s 44(2)) and obtain the required witness certifications (s 45).
   • Record the declaration in the medical record (s 46) and give a copy to the Board within 5 business days (s 47), noting the maximum penalty.

6. Final request and final review (ss 48-52)

   • The patient may make a final request in person (or audiovisual if not practicable) after the consulting assessment is complete and not before the end of the designated period unless early final request criteria are met (ss 48-49).
   • The coordinating practitioner must record the final request date and reasons if made early (s 50) and complete the final request form for the Board within 5 business days (s 51).
   • On receipt of final request, the coordinating practitioner must perform the final review: review all consulting assessment forms and the