South Australia: Voluntary Assisted Dying Act 2021 (SA)

South Australia Voluntary Assisted Dying Act 2021 An Act to provide for and regulate access to voluntary assisted dying, to establish the Voluntary Assisted Dying Review Board, to make related amendments to other Acts, and for other purposes. Contents Part 1—Preliminary 1 Short title 2 Commencement 3 Interpretation 4 Meaning of decision making capacity 5 Voluntary assisted dying not palliative care 6 Voluntary assisted dying not suicide 7 Interpreters 8 Principles 9 When may a person access voluntary assisted dying 10 Conscientious objection of registered health practitioners 11 Conscientious objection of operators of certain health service establishments 12 Voluntary assisted dying must not be initiated by registered health practitioner 13 Chief Executive may approve training for medical practitioners 14 Delegations Part 2—Conscientious objection of operators of certain residential facilities Division 1—Preliminary 15 Interpretation 16 Meaning of permanent residents of certain facilities Division 2—Information about voluntary assisted dying 17 Access to information about voluntary assisted dying Division 3—Request and assessment process 18 Application of Division 19 First requests and final requests 20 First assessments 21 Consulting assessments 22 Written declarations 23 Application for voluntary assisted dying permit Division 4—Accessing voluntary assisted dying and death 24 Administration of voluntary assisted dying substance Division 5—Information about non‑availability of voluntary assisted dying at certain facilities 25 Relevant entities to inform public of non‑availability of voluntary assisted dying at facility Part 3—Criteria for access to voluntary assisted dying 26 Criteria for access to voluntary assisted dying Part 4—Requesting access to voluntary assisted dying and assessment of eligibility Division 1—Minimum requirements for coordinating medical practitioners and consulting medical practitioners 27 Minimum requirements for coordinating medical practitioners and consulting medical practitioners 28 Certain registered medical practitioners not eligible to act as coordinating medical practitioner etc for person Division 2—First request 29 Person may make first request to registered medical practitioner 30 No obligation to continue after making first request 31 Registered medical practitioner must accept or refuse first request 32 Registered medical practitioner who accepts first request must record first request and acceptance 33 Registered medical practitioner who accepts first request becomes coordinating medical practitioner Division 3—First assessment 34 Commencement of first assessment 35 Coordinating medical practitioner must not commence first assessment unless approved assessment training completed 36 Referral for specialist opinion 37 Information to be provided if coordinating medical practitioner assesses person as meeting eligibility criteria 38 Outcome of first assessment 39 Recording and notification of outcome of first assessment 40 Referral for consulting assessment if person assessed as eligible Division 4—Consulting assessment 41 Registered medical practitioner must accept or refuse referral for a consulting assessment 42 Registered medical practitioner who accepts referral becomes consulting medical practitioner 43 Commencement of consulting assessment 44 Consulting medical practitioner must not commence consulting assessment unless approved assessment training completed 45 Referral for specialist opinion 46 Information to be provided if consulting medical practitioner assesses person as meeting eligibility criteria 47 Outcome of consulting assessment 48 Recording and notification of outcome of consulting assessment 49 Coordinating medical practitioner may refer person assessed as ineligible for further consulting assessment 50 Coordinating medical practitioner may transfer role of coordinating medical practitioner 51 Process for transfer of coordinating medical practitioner role Division 5—Written declaration 52 Person assessed as eligible for access to voluntary assisted dying may make written declaration 53 Witness to making of written declaration 54 Certification of witness to signing of written declaration Division 6—Final request, contact person and final review by coordinating medical practitioner 55 Person may make final request 56 Final request to be made a certain time after first request and consulting assessment 57 Contact person 58 Formal requirements for appointment of contact person 59 Final review by coordinating medical practitioner on receipt of final request 60 Technical error not to invalidate request and assessment process 61 Coordinating medical practitioner may apply for voluntary assisted dying permit on certification of request and assessment process on final review 62 No obligation for person to continue after certification of request and assessment process on final review Part 5—Voluntary assisted dying permits Division 1—Authorisations under voluntary assisted dying permit 63 What is authorised by self administration permit 64 What is authorised by practitioner administration permit Division 2—Voluntary assisted dying permits 65 Application for self administration permit 66 Application for practitioner administration permit 67 Chief Executive to determine application for a voluntary assisted dying permit 68 Operation of voluntary assisted dying permit 69 Return of any dispensed voluntary assisted dying substance 70 Cancellation of self administration permit Division 3—Later physical incapacity of person to self administer voluntary assisted dying substance 71 Person may request coordinating medical practitioner apply for a practitioner administration permit 72 Destruction of unfilled prescription by coordinating medical practitioner 73 Coordinating medical practitioner may apply for a practitioner administration permit Part 6—Accessing voluntary assisted dying and death Division 1—Prescribing, dispensing or disposing of voluntary assisted dying substance 74 Information to be given on prescribing a voluntary assisted dying substance 75 Information to be given by pharmacist dispensing a prescribed voluntary assisted dying substance 76 Labeling requirements for voluntary assisted dying substance 77 Pharmacist to record and notify of voluntary assisted dying substance dispensed 78 Secure storage of voluntary assisted dying substance 79 Pharmacist at dispensing pharmacy to dispose of returned voluntary assisted dying substance 80 Pharmacist at dispensing pharmacy to record and notify of disposal of returned voluntary assisted dying substance Division 2—Administration request and administration of voluntary assisted dying substance 81 Person may make administration request 82 Witness to administration request and administration of voluntary assisted dying substance 83 Certification by coordinating medical practitioner following administration of voluntary assisted dying substance Division 3—Notification of cause of death 84 Notification of disease, illness or medical condition of person to the Registrar and Coroner Part 7—Review of decisions by South Australian Civil and Administrative Tribunal 85 Review of decisions by South Australian Civil and Administrative Tribunal 86 Notice requirements 87 No further action to be taken in relation to access to voluntary assisted dying if application to Tribunal in existence 88 Application to Tribunal for review taken to be withdrawn in certain circumstances 89 Coordinating medical practitioner or consulting medical practitioner may refuse to continue process Part 8—Notifications and protections from liability Division 1—Notifications to Australian Health Practitioner Regulation Agency 90 Mandatory notification by registered health practitioner 91 Mandatory notification by employer 92 Voluntary notification by persons 93 Protection from liability for persons making notifications Division 2—Protection from liability for those who assist, facilitate, do not act or act in accordance with this Act 94 Protection from criminal liability of person who assists or facilitates request for or access to voluntary assisted dying 95 No liability for registered health practitioner who acts in accordance with this Act 96 No liability for registered health practitioner or ambulance paramedic present after person administered voluntary assisted dying substance 97 Certain provisions of Criminal Law Consolidation Act 1935 not to apply Part 9—Offences 98 Offence not to comply with practitioner administration permit 99 Offence for person to administer voluntary assisted dying substance to another person—self administration permit 100 Offence to induce another person to request voluntary assisted dying 101 Offence to induce self administration of a voluntary assisted dying substance 102 Offence to falsify form or record 103 Offence to make a false statement 104 Offence for contact person to fail to return unused or remaining voluntary assisted dying substance after death of person who is the subject of a self administration permit 105 Offence to fail to give copies of forms to the Board 106 Criminal liability of officers of body corporate—failure to exercise due diligence Part 10—Voluntary Assisted Dying Review Board Division 1—Voluntary Assisted Dying Review Board 107 Establishment of Voluntary Assisted Dying Review Board 108 Terms and conditions of membership 109 Presiding member and deputy presiding member 110 Board's procedures 111 Committees 112 Use of staff etc of Public Service 113 Functions and powers of the Board 114 Delegation 115 Board may seek external advice Division 2—Request for information, referral of identifying information held by the Board and notifications 116 Request for information by the Board 117 Referral of identifying information to others 118 Board to notify registered medical practitioner, pharmacist or Chief Executive on receipt of certain forms 119 Board to provide information to the contact person after the notification of the person's death Division 3—Reports and statistical information 120 Annual report 121 Report of the Board on request of the Minister or Chief Executive 122 Board may provide other reports 123 Contents of reports 124 Board to record, retain and make public statistical information Part 11—Miscellaneous 125 Confidentiality 126 Victimisation 127 Service 128 Minister to report annually on palliative care spending 129 Review of Act 130 Regulations Schedule 1—Related amendments and transitional provisions etc Part 1—Preliminary 1 Amendment provisions Part 2—Amendment of Advance Care Directives Act 2013 2 Insertion of section 7A 7A Interaction with Voluntary Assisted Dying Act 3 Amendment of section 12—Provisions that cannot be included in advance care directives 4 Amendment of section 23—Powers of substitute decision maker Part 3—Amendment of Consent to Medical Treatment and Palliative Care Act 1995 5 Insertion of section 4C 4C Interaction with Voluntary Assisted Dying Act Part 4—Amendment of Coroners Act 2003 6 Amendment of section 3—Interpretation Part 5—Amendment of Criminal Law Consolidation Act 1935 7 Amendment of section 13A—Criminal liability in relation to suicide Legislative history The Parliament of South Australia enacts as follows: Part 1—Preliminary 1—Short title This Act may be cited as the Voluntary Assisted Dying Act 2021. 2—Commencement This Act comes into operation on a day to be fixed by proclamation. 3—Interpretation In this Act, unless the contrary intention appears— administration request means a request made under section 81 for the administration of a voluntary assisted dying substance; approved assessment training means training approved by the Minister under section 13; Australian Health Practitioner Regulation Agency means the Australian Health Practitioner Regulation Agency established under the Health Practitioner Regulation National Law; Chief Executive means the Chief Executive of the administrative unit of the Public Service that is responsible for assisting a Minister in the administration of the Health Care Act 2008; consulting assessment means an assessment of a person conducted in accordance with Part 4 Division 4 by a consulting medical practitioner for the person; consulting assessment report form means the consulting assessment report form prescribed by the regulations, completed under section 48; consulting medical practitioner for a person means a registered medical practitioner who accepts a referral to conduct a consulting assessment of the person; contact person means a person appointed under section 57; contact person appointment form means the contact person appointment form prescribed by the regulations, completed under section 58; controlled substance has the same meaning as in the Controlled Substances Act 1984; coordinating medical practitioner for a person means a person who is— (a) a registered medical practitioner who accepts the person's first request; or (b) a consulting medical practitioner for the person who accepts a transfer of the role of coordinating medical practitioner under section 51; coordinating medical practitioner administration form means the coordinating medical practitioner administration form prescribed by the regulations, completed by a witness under section 82 and a coordinating medical practitioner under section 83; decision-making capacity—see section 4; de‑identified, in relation to personal information or health information, means personal information or health information that no longer relates to an identifiable individual or an individual who can be reasonably identified; dispensing pharmacy means the pharmacy, pharmacy business or pharmacy department from which a pharmacist sold or supplied a voluntary assisted dying substance; domestic partner has the same meaning as in the Family Relationships Act 1975 (whether or not a declaration of the relationship has been made under that Act) but does not, in the case of persons in a close personal relationship within the meaning of Part 3 of that Act, include a person who provides domestic support and personal care to the person— (a) for fee or reward; or (b) on behalf of another person or an organisation (including a government, a government agency, a body corporate or a charitable or benevolent organisation); drug of dependence has the same meaning as in the Controlled Substances Act 1984; eligibility criteria means the criteria set out in section 26; family member of a person means the person's spouse or domestic partner, parent, sibling, child or grandchild; final request means a request for access to voluntary assisted dying made under section 55 by a person to the coordinating medical practitioner for the person; final review means a review conducted under section 59 by the coordinating medical practitioner for the person; final review form means the final review form prescribed by the regulations, completed under section 59; first assessment means an assessment of a person conducted in accordance with Part 4 Division 3 by the coordinating medical practitioner for the person; first assessment report form means the first assessment report form prescribed by the regulations, completed under section 39; first request means a request for access to voluntary assisted dying made under section 29 by a person to a registered medical practitioner; prescribed health facility means— (a) an incorporated or private hospital within the meaning of the Health Care Act 2008; or (b) a residential care service or aged care service; or (c) a supported residential facility under the Supported Residential Facilities Act 1992; or (d) a treatment centre within the meaning of the Mental Health Act 2009; or (e) any other facility of a kind prescribed by the regulations; health information means— (a) personal information relating to— (i) the physical, mental or psychological health (at any time) of a person; or (ii) a disability (at any time) of a person; or (iii) a person's expressed wishes about the future provision of health services to the person; or (iv) a health service provided, or to be provided, to a person; or (b) personal information collected to provide, or in providing, a health service; or (c) personal information about a person collected in connection with the donation, or intended donation, by the person of body parts, organs or body substances; or (d) personal information that is genetic information about a person in a form which is or could be predictive of the health (at any time) of the person or of any of their descendants, but does not include health information, or a class of health information or health information contained in a class of documents, of a kind prescribed by the regulations; health service has the same meaning as in the Health Practitioner Regulation National Law; identifying information means health information or personal information about a person whose identity is apparent, or can reasonably be ascertained, from that information; ineligible witness—see section 53(2); interpreter—see section 7; labeling statement means a statement attached to a container as required by section 76(1); mental illness has the same meaning as in the Mental Health Act 2009; palliative care has the same meaning as in the Consent to Medical Treatment and Palliative Care Act 1995; personal information means information or an opinion, including information or an opinion forming part of a database, whether true or not, and whether recorded in a material form or not, about an individual whose identity is apparent, or can reasonably be ascertained, from the information or opinion; pharmacist means a person registered under the Health Practitioner Regulation National Law to practise in the pharmacy profession (other than as a student); pharmacy has the same meaning as in the Health Practitioner Regulation National Law (South Australia) Act 2010; pharmacy business has the same meaning as in the Health Practitioner Regulation National Law (South Australia) Act 2010; pharmacy department means the part of the premises of a health service set aside for supplying, compounding or dispensing medicines on order or prescription to patients and staff of the health service; poison has the same meaning as in the Controlled Substances Act 1984; practitioner administration permit means a permit issued under section 67(2)(a)(ii); professional care services means any of the following provided to another person under a contract of employment or a contract for services: (a) support or assistance; (b) special or personal care; (c) disability services; (d) services provided by a registered NDIS provider within the meaning of the National Disability Insurance Scheme Act 2013 of the Commonwealth; psychiatrist means a person who is registered under the Health Practitioner Regulation National Law as a medical practitioner in the speciality of psychiatry (other than as a student); registered health practitioner means a person registered under the Health Practitioner Regulation National Law to practise a health profession (other than as a student); Registrar means the Registrar of Births, Deaths and Marriages under the Births, Deaths and Marriages Registration Act 1996; request and assessment process means, in respect of a person, the making or the conducting of the following under Part 4: (a) a first request; (b) a first assessment; (c) a consulting assessment; (d) a written declaration; (e) a final request; (f) a contact person appointment; (g) a final review; self administration permit means a permit issued under section 67(2)(a)(i); special or personal care means— (a) assistance with 1 or more of the following: (i) bathing, showering or personal hygiene; (ii) toileting; (iii) dressing or undressing; (iv) meals; or (b) assistance for persons with mobility problems; or (c) assistance for persons who are mobile but require some form of supervision or assistance; or (d) assistance or supervision in administering medicine; or (e) the provision of substantial emotional support; supply has the same meaning as in the Controlled Substances Act 1984; Tribunal means the South Australian Civil and Administrative Tribunal established under the South Australian Civil and Administrative Tribunal Act 2013; Uniform Poisons Standard means the current Poisons Standard as defined in the Therapeutic Goods Act 1989 of the Commonwealth (as in force from time to time); vocationally registered general practitioner has the same meaning as in the Health Insurance Act 1973 of the Commonwealth; voluntary assisted dying means the administration of a voluntary assisted dying substance and includes steps reasonably related to such administration; voluntary assisted dying permit means— (a) a self administration permit; or (b) a practitioner administration permit; Voluntary Assisted Dying Review Board or Board means the Voluntary Assisted Dying Review Board established under section 107; voluntary assisted dying substance means a poison or controlled substance or a drug of dependence specified in a voluntary assisted dying permit for the purpose of causing a person's death; voluntary assisted dying substance dispensing form means the voluntary assisted dying substance dispensing form prescribed by the regulations, completed by a pharmacist under section 77; voluntary assisted dying substance disposal form means the voluntary assisted dying substance disposal form prescribed by the regulations, completed by a pharmacist under section 80; written declaration means a declaration made under section 52 in the form prescribed by the regulations. 4—Meaning of decision making capacity (1) A person has decision making capacity in relation to voluntary assisted dying if the person is able to— (a) understand the information relevant to the decision relating to access to voluntary assisted dying and the effect of the decision; and (b) retain that information to the extent necessary to make the decision; and (c) use or weigh that information as part of the process of making the decision; and (d) communicate the decision and the person's views and needs as to the decision in some way, including by speech, gestures or other means. (2) For the purposes of subsection (1), a person is presumed to have decision making capacity unless there is evidence to the contrary. (3) For the purposes of subsection (1)(a), a person is taken to understand information relevant to a decision if the person understands an explanation of the information given to the person in a way that is appropriate to the person's circumstances, whether by using modified language, visual aids or any other means. (4) In determining whether or not a person has decision making capacity, regard must be had to the following: (a) a person may have decision making capacity to make some decisions and not others; (b) if a person does not have decision making capacity to make a particular decision, it may be temporary and not permanent; (c) it should not be assumed that a person does not have decision making capacity to make a decision— (i) on the basis of the person's appearance; or (ii) because the person makes a decision that is, in the opinion of others, unwise; (d) a person has decision making capacity to make a decision if it is possible for the person to make a decision with practicable and appropriate support. Example— Practicable and appropriate support includes things such as— (a) using information or formats tailored to the particular needs of a person; (b) communicating or assisting a person to communicate the person's decision; (c) giving a person additional time and discussing the matter with the person; (d) using technology that alleviates the effects of a person's disability. (5) A person who is assessing whether a person has decision making capacity for the purposes of this Act must take reasonable steps to conduct the assessment at a time and in an environment in which the person's decision making capacity can be most accurately assessed. 5—Voluntary assisted dying not palliative care (1) For the purposes of the law of the State, the administration of a voluntary assisted dying substance to a person in accordance with, or purportedly in accordance with, this Act will be taken not to constitute palliative care of the person. (2) To avoid doubt, nothing in subsection (1) prevents a person who is providing, or who has provided, palliative care to a person, or an institution at which palliative care is provided to a person, from performing functions or otherwise being involved in the operation of this Act (whether as a coordinating medical practitioner, a consulting medical practitioner or otherwise). (3) Nothing in this Act limits Part 3 Division 2 of the Consent to Medical Treatment and Palliative Care Act 1995 (and, for the purposes of section 17(1) of that Division, a reference to administering medical treatment in that subsection will be taken not to include a reference to administering a voluntary assisted dying substance to a person in accordance with, or purportedly in accordance with, this Act). Note— Section 17 of the Consent to Medical Treatment and Palliative Care Act 1995 provides that a medical practitioner does not incur liability where certain medical treatment incidentally, rather than intentionally, hastens the death of a patient. 6—Voluntary assisted dying not suicide (1) For the purposes of the laws of the State, the death of a person by the administration of a voluntary assisted dying substance in accordance with this Act will be taken not to constitute the death by suicide of the person. (2) Without limiting subsection (1), for the purposes of the laws of the State, and any professional standard or code of conduct (however described), a person who performs an act or omission in relation to the voluntary assisted dying of a person in accordance with this Act will be taken not, by that act or omission alone, to have aided, abetted, counselled or procured the suicide of the other person. 7—Interpreters For the purposes of this Act, an interpreter who assists a person in relation to requesting access to or accessing voluntary assisted dying— (a) must be accredited by a prescribed body; and (b) must not— (i) be a family member of the person; or (ii) believe or have knowledge of— (A) being a beneficiary under a will of the person; or (B) otherwise benefitting financially or in any other material way from the death of the person; or (iii) be an owner of, or be responsible for the day-to-day management and operation of, any prescribed health facility at which the person is being treated or resides; or (iv) be a person who is directly involved in providing health services or professional care services to the person. 8—Principles (1) A person exercising a power or performing a function or duty under this Act must have regard to the following principles: (a) every human life has equal value; (b) a person's autonomy should be respected; (c) a person has the right to be supported in making informed decisions about the person's medical treatment, and should be given, in a manner the person understands, information about medical treatment options including comfort and palliative care; (d) every person approaching the end of life should be provided with quality care to minimise the person's suffering and maximise the person's quality of life; (e) a therapeutic relationship between a person and the person's health practitioner should, wherever possible, be supported and maintained; (f) individuals should be encouraged to openly discuss death and dying and an individual's preferences and values should be encouraged and promoted; (g) individuals should be supported in conversations with the individual's health practitioners, family and carers and community about treatment and care preferences; (h) individuals are entitled to genuine choices regarding their treatment and care; (i) there is a need to protect individuals who may be subject to abuse; (j) all persons, including health practitioners, have the right to be shown respect for their culture, beliefs, values and personal characteristics; (k) every person has the right to make decisions about medical treatment options freely and not as a consequence of the suggestion, pressure, coercion or undue influence of others. (2) For the purposes of subsection (1), a reference to a person exercising a power or performing a function or duty under this Act will be taken to include the Tribunal. 9—When may a person access voluntary assisted dying A person may access voluntary assisted dying if— (a) the person has made a first request; and (b) the person has been assessed as eligible for access to voluntary assisted dying by— (i) the coordinating medical practitioner for the person; and (ii) a consulting medical practitioner for the person; and (c) the person has made a written declaration; and (d) the person has made a final request to the coordinating medical practitioner; and (e) the person has appointed a contact person; and (f) the coordinating medical practitioner has certified in a final review form that the request and assessment process has been completed as required by this Act; and (g) the person is the subject of a voluntary assisted dying permit. 10—Conscientious objection of registered health practitioners A registered health practitioner who has a conscientious objection to voluntary assisted dying has the right to refuse to do any of the following: (a) to provide information about voluntary assisted dying; (b) to participate in the request and assessment process; (c) to apply for a voluntary assisted dying permit; (d) to supply, prescribe or administer a voluntary assisted dying substance; (e) to be present at the time of administration of a voluntary assisted dying substance; (f) to dispense a prescription for a voluntary assisted dying substance. 11—Conscientious objection of operators of certain health service establishments (1) A relevant service provider has the right to refuse to authorise or permit the carrying out, at a health service establishment operated by the relevant service provider, of any part of the voluntary assisted dying process in relation to any patient at the establishment (including any request or assessment process under this Act). (2) A relevant service provider may include in the terms and conditions of acceptance of any patient into the health service establishment an acknowledgment by the patient that the patient— (a) understands and accepts that the relevant service provider will not permit the establishment to be used for the purposes of, or incidental to, voluntary assisted dying; and (b) agrees, as a condition of entry, that they will not seek or demand access to voluntary assisted dying at the establishment. (3) Subsection (4) applies in relation to a patient at a health service establishment if the patient advises a person employed or engaged by the relevant service provider at that health service establishment that they wish to access voluntary assisted dying. (4) If this subsection applies in relation to a patient at a health service establishment, the relevant service provider who operates the establishment must ensure that— (a) the patient is advised of the relevant service provider's refusal to authorise or permit the carrying out at the health service establishment of any part of the voluntary assisted dying process; and (b) arrangements are in place whereby the patient may be transferred to another health service establishment or prescribed health facility at which, in the opinion of the relevant service provider, a registered health practitioner who does not have a conscientious objection to voluntary assisted dying is likely to be able to participate in a voluntary assisted dying process in relation to the patient; and (c) reasonable steps are taken to facilitate the transfer referred to in paragraph (b) if requested by the patient. (5) To avoid doubt, this section does not apply to, or in relation to, a patient accepted into a health service establishment before the commencement of this section. (6) In this section— health service establishment means— (a) a private hospital within the meaning of the Health Care Act 2008 or other private health facility of a kind prescribed by the regulations; or (b) the whole or part of any other private institution, facility, building or place that is operated or designed to provide inpatient or outpatient treatment, diagnostic or therapeutic interventions, nursing, rehabilitative, palliative, convalescent, preventative or other health services (including, to avoid doubt, places of short‑term respite care); or (c) any other health service establishment of a kind prescribed by the regulations, but does not include prescribed residential premises, or any establishment declared by the regulations not to be included in the ambit of this definition; prescribed residential premises means— (a) a facility (within the meaning of Part 2); (b) any other residential premises of a kind prescribed by the regulations; relevant service provider means a person or body that operates a health service establishment. 12—Voluntary assisted dying must not be initiated by registered health practitioner (1) A registered health practitioner who provides health services or professional care services to a person must not, in the course of providing those services to the person— (a) initiate discussion with that person that is in substance about voluntary assisted dying; or (b) in substance, suggest voluntary assisted dying to that person. (2) Nothing in subsection (1) prevents a registered health practitioner providing information about voluntary assisted dying to a person at that person's request. (3) A contravention of subsection (1) is to be regarded as unprofessional conduct within the meaning and for the purposes of the Health Practitioner Regulation National Law. 13—Chief Executive may approve training for medical practitioners The Chief Executive, by notice published in the Gazette, may approve training relating to the following matters: (a) requirements under this Act relating to coordinating medical practitioners and consulting medical practitioners, including functions of coordinating medical practitioners and consulting medical practitioners; (b) assessing whether or not a person meets the eligibility criteria; (c) identifying and assessing risk factors for abuse or coercion. 14—Delegations (1) The Minister may delegate a function or power conferred on the Minister under this Act— (a) to a specified person or body; or (b) to a person occupying or acting in a specified office or position. (2) The Chief Executive may delegate a function or power conferred on the Chief Executive under this Act— (a) to a specified person or body; or (b) to a person occupying or acting in a specified office or position. (3) A delegation— (a) must be in writing; and (b) may be made subject to conditions or limitations specified in the instrument of delegation; and (c) if the instrument of delegation so provides, may be further delegated by the delegate; and (d) is revocable at will and does not prevent the delegator from acting personally in a matter. Part 2—Conscientious objection of operators of certain residential facilities Division 1—Preliminary 15—Interpretation In this Part— deciding practitioner, for a decision about the transfer of a person, means— (a) the coordinating medical practitioner for the person; or (b) if the coordinating medical practitioner for the person is not available, another medical practitioner nominated by the person; facility means— (a) a nursing home, hostel or other facility at which accommodation, nursing or personal care is provided to persons on a residential basis who, because of infirmity, illness, disease, incapacity or disability, have a need for nursing or personal care; or (b) a residential aged care facility; or (c) a retirement village (within the meaning of the Retirement Villages Act 2016); relevant entity means an entity, other than a natural person, that provides a relevant service; relevant service means a residential aged care service or a personal care service, or services provided in the course of administering a retirement village scheme (within the meaning of the Retirement Villages Act 2016); residential aged care means personal care or nursing care (or both) that is provided to a person in a residential facility in which the person is also provided with accommodation that includes— (a) staffing to meet the nursing and personal care needs of the person; and (b) meals and cleaning services; and (c) furnishings, furniture and equipment for the provision of that care and accommodation; residential aged care facility means a facility at which residential aged care is provided, whether or not the care is provided by an entity that is an approved provider under the Aged Care Quality and Safety Commission Act 2018 of the Commonwealth; residential facility does not include— (a) a private home; or (b) a hospital or psychiatric facility; or (c) a facility that primarily provides care to people who are not frail and aged. 16—Meaning of permanent residents of certain facilities (1) A person is a permanent resident at a facility if the facility is the person's settled and usual place of abode where the person regularly or customarily lives. (2) A person is a permanent resident at a facility that is a residential aged care facility if the person has security of tenure at the facility under the Aged Care Act 1997 of the Commonwealth or on some other basis. (3) A person is not a permanent resident at a facility if the person resides at the facility temporarily. Division 2—Information about voluntary assisted dying 17—Access to information about voluntary assisted dying (1) This section applies if— (a) a person is receiving relevant services from a relevant entity at a facility; and (b) the person asks the entity for information about voluntary assisted dying; and (c) the entity does not provide at the facility, to persons to whom relevant services are provided, the information that has been requested. (2) The relevant entity and any other entity that owns or occupies the facility— (a) must not hinder the person's access at the facility to information about voluntary assisted dying; and (b) must, on request, allow reasonable access to the person at the facility by a registered health practitioner or other person to enable the registered health practitioner or other person to personally provide the requested information about voluntary assisted dying to the person. Division 3—Request and assessment process 18—Application of Division This Division applies if a person is receiving relevant services from a relevant entity at a facility. 19—First requests and final requests (1) This section applies if— (a) the person or the person's agent advises the relevant entity that the person wishes to make a first request or final request (each a relevant request); and (b) the entity does not provide, to persons to whom relevant services are provided at the facility, access to the request and assessment process at the facility. (2) The relevant entity and any other entity that owns or occupies the facility must allow reasonable access to the person at the facility by a medical practitioner— (a) whose presence is requested by the person; and (b) who— (i) for a first request—is eligible to act as a coordinating medical practitioner; or (ii) for a final request—is the coordinating medical practitioner for the person. (3) If the requested medical practitioner is not available to attend, the relevant entity must take reasonable steps to facilitate the transfer of the person to and from a place where the person's relevant request may be made to— (a) the requested medical practitioner; or (b) another medical practitioner who is eligible and willing to act as a coordinating medical practitioner. 20—First assessments (1) This section applies if— (a) the person has made a first request; and (b) the person or the person's agent advises the relevant entity that the person wishes to undergo a first assessment; and (c) the entity does not provide, to persons to whom relevant services are provided at the facility, access to the request and assessment process at the facility. (2) If the person is a permanent resident at the facility— (a) the relevant entity and any other entity that owns or occupies the facility must allow reasonable access to the person at the facility by a relevant practitioner for the person to assess the person; and (b) if a relevant practitioner is not available to attend—the relevant entity must take reasonable steps to facilitate the transfer of the person to and from a place where the person's assessment may be carried out by— (i) the relevant practitioner; or (ii) another medical practitioner who is eligible and willing to act as a relevant practitioner. (3) If the person is not a permanent resident at the facility— (a) the relevant entity must take reasonable steps to facilitate the transfer of the person to and from a place where the person's first assessment may be carried out by a relevant practitioner for the person; or (b) if, in the opinion of the deciding practitioner, transfer of the person as described in paragraph (a) would not be reasonable in the circumstances, the entity and any other entity that owns or occupies the facility must allow reasonable access to the person at the facility by a relevant practitioner for the person. (4) In making a decision referred to in subsection (3)(b), the deciding practitioner must have regard to the following: (a) whether the transfer would be likely to cause serious harm to the person; (b) whether the transfer would be likely to adversely affect the person's access to voluntary assisted dying; (c) whether the transfer would cause undue delay and prolonged suffering in accessing voluntary assisted dying; (d) whether the place to which the person is proposed to be transferred is available to receive the person; (e) whether the person would incur financial loss or costs because of the transfer. (5) In this section— relevant practitioner for a person, means— (a) the coordinating medical practitioner for the person; or (b) a registered health practitioner to whom the coordinating medical practitioner for the person has referred a matter under section 36. 21—Consulting assessments (1) This section applies if— (a) the person has undergone a first assessment; and (b) the person or the person's agent advises the relevant entity that the person wishes to undergo a consulting assessment; and (c) the entity does not provide, to persons to whom relevant services are provided at the facility, access to the request and assessment process at the facility. (2) If the person is a permanent resident at the facility— (a) the relevant entity and any other entity that owns or occupies the facility must allow reasonable access to the person at the facility by a relevant practitioner for the person to assess the person; and (b) if a relevant practitioner is not available to attend—the relevant entity must take reasonable steps to facilitate the transfer of the person to and from a place where the person's assessment may be carried out by— (i) the relevant practitioner; or (ii) another medical practitioner who is eligible and willing to act as a relevant practitioner. (3) If the person is not a permanent resident at the facility— (a) the relevant entity must take reasonable steps to facilitate the transfer of the person to and from a place where the person's assessment may be carried out by a relevant practitioner for the person; or (b) if, in the opinion of the deciding practitioner, transfer of the person as described in paragraph (a) would not be reasonable in the circumstances, the entity and any other entity that owns or occupies the facility must allow reasonable access to the person at the facility by a relevant practitioner for the person. (4) In making a decision referred to in subsection (3)(b), the deciding practitioner must have regard to the following: (a) whether the transfer would be likely to cause serious harm to the person; (b) whether the transfer would be likely to adversely affect the person's access to voluntary assisted dying; (c) whether the transfer would cause undue delay and prolonged suffering in accessing voluntary assisted dying; (d) whether the place to which the person is proposed to be transferred is available to receive the person; (e) whether the person would incur financial loss or costs because of the transfer. (5) In this section— relevant practitioner for a person, means— (a) the consulting medical practitioner for the person; or (b) a registered health practitioner to whom the consulting medical practitioner for the person has referred a matter under section 45. 22—Written declarations (1) This section applies if— (a) the person has been assessed as eligible for access to voluntary assisted dying; and (b) the person or the person's agent advises the relevant entity that the person wishes to make a written declaration; and (c) the entity does not provide, to persons to whom relevant services are provided at the facility, access to the request and assessment process at the facility. (2) If the person is a permanent resident at the facility— (a) the relevant entity and any other entity that owns or occupies the facility must allow reasonable access to the person at the facility by the coordinating medical practitioner for the person and any other person lawfully participating in the person's request for access to voluntary assisted dying to enable the person to make a written declaration; and (b) if the coordinating medical practitioner is not available to attend—the relevant entity must take reasonable steps to facilitate the transfer of the person to and from a place where the person may make a written declaration. (3) If the person is not a permanent resident at the facility— (a) the relevant entity must take reasonable steps to facilitate the transfer of the person to and from a place where the person may make a written declaration; or (b) if, in the opinion of the deciding practitioner, transfer of the person as described in paragraph (a) would not be reasonable in the circumstances, the entity and any other entity that owns or occupies the facility must allow reasonable access to the person at the facility by a relevant practitioner for the person and any other person lawfully participating in the person's request for access to voluntary assisted dying. (4) In making a decision referred to in subsection (3)(b), the deciding practitioner must have regard to the following: (a) whether the transfer would be likely to cause serious harm to the person; (b) whether the transfer would be likely to adversely affect the person's access to voluntary assisted dying; (c) whether the transfer would cause undue delay and prolonged suffering in accessing voluntary assisted dying; (d) whether the place to which the person is proposed to be transferred is available to receive the person; (e) whether the person would incur financial loss or costs because of the transfer. (5) In this section— relevant practitioner for a person, means— (a) the coordinating medical practitioner for the person; or (b) a registered health practitioner to whom the coordinating medical practitioner for the person has referred a matter under section 45. 23—Application for voluntary assisted dying permit (1) This section applies if— (a) the person has made a final request; and (b) the person or the person's agent advises the relevant entity that the person wishes to make an application for a voluntary assisted dying permit; and (c) the entity does not provide, to persons to whom relevant services are provided at the facility, access to a person's coordinating medical practitioner to enable such an application to be made. (2) If the person is a permanent resident at the facility— (a) the relevant entity and any other entity that owns or occupies the facility must allow reasonable access to the person at the facility by the coordinating medical practitioner for the person to consult with and assess the person in relation to the application; and (b) if the coordinating medical practitioner is not available to attend—the relevant entity must take reasonable steps to facilitate the transfer of the person to and from a place where consultation and assessment of the person can occur in relation to the application in consultation with, and on the advice of— (i) the coordinating medical practitioner; or (ii) another medical practitioner who is eligible and willing to act as the coordinating medical practitioner for the person. (3) If the person is not a permanent resident at the facility— (a) the relevant entity must take reasonable steps to facilitate the transfer of the person to and from a place where the coordinating medical practitioner for the person can consult with and assess the person in relation to the application; or (b) if, in the opinion of the deciding practitioner, transfer of the person as described in paragraph (a) would not be reasonable in the circumstances—the relevant entity and any other entity that owns or occupies the facility must allow reasonable access to the person at the facility by the coordinating medical practitioner for the person to consult with and assess the person in relation to the application. (4) In making a decision referred to in subsection (3)(b), the deciding practitioner must have regard to the following— (a) whether the transfer would be likely to cause serious harm to the person; (b) whether the transfer would be likely to adversely affect the person's access to voluntary assisted dying; (c) whether the transfer would cause undue delay and prolonged suffering in accessing voluntary assisted dying; (d) whether the place to which the person is proposed to be transferred is available to receive the person; (e) whether the person would incur financial loss or costs because of the transfer. Division 4—Accessing voluntary assisted dying and death 24—Administration of voluntary assisted dying substance (1) This section applies if— (a) an application for a voluntary assisted dying permit has been made in respect of the person and a permit issued; and (b) the person or the person's agent advises the relevant entity that the person wishes to self administer a voluntary assisted dying substance or have the coordinating medical practitioner for the person administer a voluntary assisted dying substance to the person; and (c) the relevant entity does not provide, to persons to whom relevant services are provided at the facility, access to the administration of a voluntary assisted dying substance at the facility. (2) If the person is a permanent resident at the facility, the relevant entity and any other entity that owns or occupies the facility must— (a) if a practitioner administration permit is issued in respect of the person—allow reasonable access to the person at the facility by the coordinating medical practitioner and any other person lawfully participating in the person's request for access to voluntary assisted dying for the person to make an administration request and for the coordinating medical practitioner to administer a voluntary assisted dying substance to the person; or (b) if a self administration permit is issued in respect of the person— (i) allow reasonable access to the person at the facility by a person lawfully delivering a voluntary assisted dying substance to the person, and any other person lawfully participating in the person's request for access to voluntary assisted dying; and (ii) not otherwise hinder access by the person to a voluntary assisted dying substance. (3) If the person is not a permanent resident at the facility— (a) the relevant entity must take reasonable steps to facilitate the transfer of the person to a place where the person may be administered or may self administer a voluntary assisted dying substance; or (b) if, in the opinion of the deciding practitioner, transfer of the person as described in paragraph (a) would not be reasonable in the circumstances, subsection (2) applies in relation to the person as if the person were a permanent resident at the facility. (4) In making the decision under subsection (3)(b), the deciding practitioner must have regard to the following— (a) whether the transfer would be likely to cause serious harm to the person; (b) whether the transfer would be likely to adversely affect the person's access to voluntary assisted dying; (c) whether the transfer would cause undue delay and prolonged suffering in accessing voluntary assisted dying; (d) whether the place to which the person is proposed to be transferred is available to receive the person; (e) whether the person would incur financial loss or costs because of the transfer. Division 5—Information about non‑availability of voluntary assisted dying at certain facilities 25—Relevant entities to inform public of non‑availability of voluntary assisted dying at facility (1) This section applies to a relevant entity that does not provide, at a facility at which the entity provides relevant services, services associated with voluntary assisted dying (including, without limiting this subsection, access to the request and assessment process or access to the administration of a voluntary assisted dying substance). (2) The relevant entity must publish information about the fact the entity does not provide any services, or services of a specified kind, associated with voluntary assisted dying at the facility. (3) The relevant entity must publish the information in a way in which it is likely that persons who receive the services of the entity at the facility, or may in future receive the services of the entity at the facility, become aware of the information. Part 3—Criteria for access to voluntary assisted dying 26—Criteria for access to voluntary assisted dying (1) For a person to be eligible for access to voluntary assisted dying— (a) the person must be aged 18 years or more; and (b) the person must— (i) be an Australian citizen or permanent resident; and (ii) be ordinarily resident in South Australia; and (iii) at the time of making a first request, have been ordinarily resident in South Australia for at least 12 months; and (c) the person must have decision making capacity in relation to voluntary assisted dying; and (d) the person must be diagnosed with a disease, illness or medical condition that— (i) is incurable; and (ii) is advanced, progressive and will cause death; and (iii) is expected to cause death within weeks or months, not exceeding 6 months; and (iv) is causing suffering to the person that cannot be relieved in a manner that the person considers tolerable; and (e) the person must be acting freely and without coercion. (2) A person is not eligible for access to voluntary assisted dying only because the person is diagnosed with a mental illness within the meaning of the Mental Health Act 2009. (3) A person is not eligible for access to voluntary assisted dying only because the person has a disability within the meaning of the Disability Inclusion Act 2018. (4) Despite subsection (1)(d)(iii), if a person is diagnosed with a disease, illness or medical condition that is neurodegenerative, that disease, illness or medical condition will be taken to be expected to cause death within weeks or months, not exceeding 12 months. Part 4—Requesting access to voluntary assisted dying and assessment of eligibility Division 1—Minimum requirements for coordinating medical practitioners and consulting medical practitioners 27—Minimum requirements for coordinating medical practitioners and consulting medical practitioners (1) Each coordinating medical practitioner and consulting medical practitioner must— (a) hold a fellowship with a specialist medical college; or (b) be a vocationally registered general practitioner. (2) Either the coordinating medical practitioner or each consulting medical practitioner must have practised as a registered medical practitioner for at least 5 years after completing a fellowship with a specialist medical college or vocational registration (as the case requires). (3) Either the coordinating medical practitioner or each consulting medical practitioner must have relevant expertise and experience in the disease, illness or medical condition expected to cause the death of the person being assessed. 28—Certain registered medical practitioners not eligible to act as coordinating medical practitioner etc for person A registered medical practitioner is not eligible to act as the coordinating medical practitioner or a consulting medical practitioner (as the case requires) for a person if the practitioner— (a) is a family member of the person; or (b) knows, or has reasonable grounds to believe, that they— (i) may be a beneficiary under a will of the person; or (ii) may otherwise benefit financially or in any other material way from the death of the person (other than by receiving reasonable fees for the provision of services as the coordinating practitioner or consulting practitioner for the person). Division 2—First request 29—Person may make first request to registered medical practitioner (1) A person may make a request to a registered medical practitioner for access to voluntary assisted dying. (2) A request for access to voluntary assisted dying must be— (a) clear and unambiguous; and (b) made by the person personally. (3) The person may make the request verbally or by gestures or other means of communication available to the person. 30—No obligation to continue after making first request (1) A person who has made a first request may decide at any time not to continue the request and assessment process. (2) The request and assessment process ends if a person decides not to continue the request and assessment process. (3) If the request and assessment process has ended under subsection (2), the person may commence a fresh request and assessment process by making a new first request. 31—Registered medical practitioner must accept or refuse first request (1) Within 7 days after receiving a first request from a person, the registered medical practitioner to whom the request was made must inform the person that the practitioner— (a) accepts the first request; or (b) refuses the first request because the practitioner— (i) has a conscientious objection to voluntary assisted dying; or (ii) believes that the practitioner will not be able to perform the duties of coordinating medical practitioner due to unavailability; or (iii) is required under subsection (2) to refuse the first request; or (iv) is not eligible to act as the coordinating medical practitioner for the person. (2) The registered medical practitioner must not accept the first request unless the practitioner— (a) holds a fellowship with a specialist medical college; or (b) is a vocationally registered general practitioner. 32—Registered medical practitioner who accepts first request must record first request and acceptance If the registered medical practitioner accepts the person's first request, the practitioner must— (a) record the practitioner's decision to accept the first request in the person's medical record; and (b) record the first request in the person's medical record. 33—Registered medical practitioner who accepts first request becomes coordinating medical practitioner On acceptance of a person's first request, the registered medical practitioner to whom the request was made becomes the coordinating medical practitioner for the person. Division 3—First assessment 34—Commencement of first assessment After becoming the coordinating medical practitioner for a person, the coordinating medical practitioner must assess whether the person requesting access to voluntary assisted dying meets the eligibility criteria. Note— The person must meet all eligibility criteria to be assessed as eligible for access to voluntary assisted dying—see section 38(1)(a). 35—Coordinating medical practitioner must not commence first assessment unless approved assessment training completed The coordinating medical practitioner must not commence the first assessment unless the practitioner has completed approved assessment training. 36—Referral for specialist opinion (1) If the coordinating medical practitioner is unable to determine whether the person has decision making capacity in relation to voluntary assisted dying as required by the eligibility criteria (for example, due to a past or current mental illness of the person), the coordinating medical practitioner must refer the person to a registered health practitioner who has appropriate skills and training (such as a psychiatrist in the case of mental illness). (2) If the coordinating medical practitioner is unable to determine whether the person's disease, illness or medical condition meets the requirements of the eligibility criteria, the coordinating medical practitioner must refer the person to a specialist registered medical practitioner who has appropriate skills and training in that disease, illness or medical condition. (3) If the coordinating medical practitioner refers the person to— (a) a registered health practitioner under subsection (1); or (b) a specialist registered medical practitioner under subsection (2), the coordinating medical practitioner may adopt the determination of the registered health practitioner or specialist registered medical practitioner (as the case requires) in relation to the matter in respect of which the person was referred. (4) If the coordinating medical practitioner is able to determine that the person has a disease, illness or medical condition that is neurodegenerative in accordance with section 26(4) that— (a) will cause death; and (b) is expected to cause death between 6 and 12 months, the coordinating medical practitioner must refer the person to a specialist registered medical practitioner who has appropriate skills and training in that particular disease, illness or medical condition that is neurodegenerative, whether or not the coordinating medical practitioner has also made a referral under subsection (2). (5) The specialist registered medical practitioner referred to in subsection (4) must— (a) determine whether the person has a disease, illness or medical condition that is neurodegenerative that— (i) will cause death; and (ii) is expected to cause death between 6 and 12 months; and (b) provide a clinical report to the coordinating medical practitioner that sets out the specialist registered medical practitioner's determination. (6) A registered health practitioner or specialist registered medical practitioner is not eligible to act in relation to the referral of a person under this section if the practitioner— (a) is a family member of the person; or (b) knows, or has reasonable grounds to believe, that they— (i) may be a beneficiary under a will of the person; or (ii) may otherwise benefit financially or in any other material way from the death of the person (other than by receiving reasonable fees for the provision of services referred to in this section). (7) If the coordinating medical practitioner refers the person to a specialist registered medical practitioner under subsection (4), the coordinating medical practitioner must adopt the determination of the specialist registered medical practitioner in respect of the matter in relation to which the person was referred. 37—Information to be provided if coordinating medical practitioner assesses person as meeting eligibility criteria (1) If the coordinating medical practitioner is satisfied that the person requesting access to voluntary assisted dying meets all the eligibility criteria, the coordinating medical practitioner must inform the person about the following matters: (a) the person's diagnosis and prognosis; (b) the treatment options available to the person and the likely outcomes of that treatment; (c) palliative care options available to the person and the likely outcomes of that care; (d) the potential risks of taking a poison or controlled substance or a drug of dependence likely to be prescribed under this Act for the purposes of causing the person's death; (e) that the expected outcome of taking a poison or controlled substance or a drug of dependence referred to in paragraph (d) is death; (f) that the person may