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Hence, they are likely to be concurrently receiving care from institutions (community nursing services, health services, palliative care services, and aged care facilities) with different levels of participation in VAD. This article reports on the various institutional approaches to VAD based on eighteen semi-structured interviews with regulators from Victoria and Western Australia, representing fifteen institutions with varying levels of support for VAD. We generated five main themes from reflexive thematic analysis of the interview data: settling on a position; operationalizing a position and determining level of involvement; local policy decisions on specific VAD activities; transparency; and navigating pluralism and accommodating diverse views. Overall, our findings revealed significant diversity in how institutions approached various VAD activities and that an institution\u2019s position on VAD (whether it supports it or not) does not necessarily indicate the extent to which it will facilitate access to VAD. These findings may have relevance for institutions seeking to implement (or revise) their approach to VAD and suggest that greater transparency about institutional approaches to VAD is needed to enable people to make informed decisions about where to seek care.<\/jats:p>","DOI":"10.1007\/s11673-024-10418-z","type":"journal-article","created":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T06:43:20Z","timestamp":1755240200000},"page":"863-880","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Institutional Responses to Voluntary Assisted Dying: An Empirical Study in Victoria and Western Australia"],"prefix":"10.1007","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9596-6654","authenticated-orcid":false,"given":"C. 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Willmott, 84\u2013112. Cambridge: Cambridge University Press."},{"key":"10418_CR55","first-page":"94","volume":"32","author":"L Willmott","year":"2025","unstructured":"Willmott, L., B.P White, and C.M. Haining. 2025. Review of the Voluntary Assisted Dying Act (WA): Research Report. Journal of Law and Medicine 32: 94\u2013160.","journal-title":"Journal of Law and Medicine"},{"key":"10418_CR56","unstructured":"Wood, E. 2022. UnitingCare Queensland joins Catholic Health Australia. The Senior, August 3. https:\/\/www.thesenior.com.au\/story\/7844197\/constitution-amendment-allows-unitingcare-qld-to-join-peak-body\/. Accessed September 1, 2024."}],"container-title":["Journal of Bioethical Inquiry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11673-024-10418-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11673-024-10418-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11673-024-10418-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T18:03:04Z","timestamp":1768154584000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11673-024-10418-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,15]]},"references-count":56,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10418"],"URL":"https:\/\/doi.org\/10.1007\/s11673-024-10418-z","relation":{},"ISSN":["1176-7529","1872-4353"],"issn-type":[{"value":"1176-7529","type":"print"},{"value":"1872-4353","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,15]]},"assertion":[{"value":"1 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that B.P. White and L. Willmott were engaged by the Victorian, Western Australian, and Queensland governments to design and provide the VAD legislatively mandated training in each of these states for medical practitioners (and nurse practitioners and nurses as appropriate) involved in VAD. C.M. Haining was employed on the Queensland project as a legal writer. B.P. White and L. Willmott were engaged to carry out the statutory review of the Voluntary Assisted Dying Act 2019 (WA), and C. M. Haining was engaged as the research fellow on that project. L. Willmott is a member of Queensland\u2019s VAD Review Board.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}