{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:05:09Z","timestamp":1790136309529,"version":"4.0.1"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Voluntary assisted dying (VAD) legislation has been implemented across all Australian states iteratively since 2019, yet the interface between VAD and palliative care remains contentious, particularly within healthcare organisations that hold policies of institutional non\u2010participation (INP). A paucity of data exists on the experience of patients who pursue VAD when under the care of specialist palliative care services (SPCSs) operating under INP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To determine the incidence, characteristics and outcomes of patients accessing VAD information within a SPCS with a policy of INP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single\u2010centre retrospective cohort study included adult patients who enquired about or engaged with VAD between 1 January 2023 and 31 December 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 2647 deaths of SPCS patients, 208 (8%) enquired about VAD and 85 (3%) died via VAD. Patients dying via VAD were predominantly older (median 76\u2009years), male (61%), with malignant disease (80%) and died at home (62%). Motivations for VAD were multifactorial, most commonly being poor quality of life and autonomy. Documentation and communication of VAD assessments and administration methods were incomplete. Where known, the VAD process was often rapid: median of 9\u2009days from first assessment to death, 36% using an expedited pathway and 37% having VAD on the day of final assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>INP SPCS play a meaningful role in providing palliative care to patients who seek information on the VAD process. These findings demonstrate a need to improve documentation and communication frameworks, explore clinician experiences in INP settings and clarify the relationship between palliative care needs and VAD engagement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/imj.70648","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T03:24:23Z","timestamp":1790133863000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["When patients seek information about voluntary assisted dying in an institutional non\u2010participating specialist palliative care service: outcomes and learnings"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4827-1041","authenticated-orcid":false,"given":"Alexander","family":"Kochi","sequence":"first","affiliation":[{"name":"Department of Palliative Care St Vincent's Private Hospital Brisbane  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2288-820X","authenticated-orcid":false,"given":"Amanda","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Palliative Care St Vincent's Private Hospital Brisbane  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8198-0375","authenticated-orcid":false,"given":"Phillip","family":"Good","sequence":"additional","affiliation":[{"name":"Department of Palliative Care St Vincent's Private Hospital Brisbane  Brisbane Queensland Australia"},{"name":"Department of Palliative and Supportive Care Mater Misericordiae Ltd  Brisbane Queensland Australia"},{"name":"Cancer Program Mater Research Institute \u2013 University of Queensland  Brisbane Queensland Australia"},{"name":"Centre for Palliative Care Research and Education, Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Australia New Zealand Society of Palliative Medicine.ANZSPM position statement on Assisted Dying (AD)\/Voluntary Assisted Dying (VAD). ANZSPM.2026(cited 2026 Apr 24). Available from URL:https:\/\/www.anzspm.org.au\/common\/Uploaded%20files\/Position%20Statements\/ANZSPM_VAD_position_statement_2026_final.pdf"},{"key":"e_1_2_7_3_1","volume-title":"Statement on Voluntary Assisted Dying","author":"The Royal Australasian College of Physicians","year":"2018"},{"key":"e_1_2_7_4_1","unstructured":"Queensland Government.Voluntary Assisted Dying Act 2021.Queensland Parliamentary Counsel.2021(cited 2026 Apr 24). Available from URL:https:\/\/www.legislation.qld.gov.au\/view\/html\/asmade\/act-2021-017"},{"key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"204","DOI":"10.5694\/mja2.50729","article-title":"Navigating the complexities of voluntary assisted dying in palliative care","volume":"213","author":"Waran E","year":"2020","journal-title":"Med J Aust"},{"key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1007\/s11673-024-10418-z","article-title":"Institutional responses to voluntary assisted dying: an empirical study in Victoria and Western Australia","volume":"22","author":"Haining CM","year":"2025","journal-title":"J Bioethical Inq"},{"key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s12910-023-00902-3","article-title":"The impact on patients of objections by institutions to assisted dying: a qualitative study of family caregivers\u2019 perceptions","volume":"24","author":"White BP","year":"2023","journal-title":"BMC Med Ethics"},{"key":"e_1_2_7_8_1","unstructured":"St Vincent's Health Australia.Voluntary Assisted Dying Bill St Vincent's Health Australia Submission.Woolloomooloo:St Vincent's Health Australia Ltd.2017(cited 2026 Apr 24). Available from URL:https:\/\/www.svha.org.au\/getmedia\/58498b98-9089-4cac-badc-c1e0fbaaa05f\/govt-submission-2017-physician_assisted_suicide_final_submission_7-4-17_victoria.pdf"},{"key":"e_1_2_7_9_1","volume-title":"Response to Voluntary Assisted Dying Act 2021 Queensland","author":"St Vincent's Private Brisbane and St Vincent's Private Hospital Northside","year":"2026"},{"key":"e_1_2_7_10_1","volume-title":"Our Enduring Commitment to End\u2010of\u2010Life Care","author":"Catholic Health and Aged Care Services in Australia","year":"2023"},{"key":"e_1_2_7_11_1","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1111\/imj.70320","article-title":"Funding the final chapter \u2013 capitation versus fee\u2010for\u2010service: a single\u2010centre, prospective cohort study comparing funding models in home\u2010based palliative care","volume":"56","author":"Kahawita T","year":"2025","journal-title":"Intern Med J"},{"key":"e_1_2_7_12_1","unstructured":"Voluntary Assisted Dying Review Board.Queensland Voluntary Assisted Dying Review Board Annual Report 2024\u20132025.Queensland Government.2025(cited 2026 Apr 24). Available from URL:https:\/\/www.health.qld.gov.au\/__data\/assets\/pdf_file\/0028\/1466146\/vad-annual-report-2024-2025.pdf"},{"key":"e_1_2_7_13_1","unstructured":"Go Gentle Australia2026 State of VAD report. Go Gentle Australia.2026(cited 2026 Apr 24). Available from URL:https:\/\/www.gogentleaustralia.org.au\/2026_state_of_vad_report"},{"key":"e_1_2_7_14_1","unstructured":"Voluntary Assisted Dying Review Board.Queensland Voluntary Assisted Dying Review Board Annual report 2023\u20132024.Queensland Government.2024(cited 2026 Apr 24). Available from URL:https:\/\/www.health.qld.gov.au\/__data\/assets\/pdf_file\/0019\/1362124\/vad-annual-report-2023-24.pdf"},{"key":"e_1_2_7_15_1","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1056\/NEJM199902183400724","article-title":"Legalized physician\u2010assisted suicide in Oregon \u2013 the first years' experience","volume":"340","author":"Chin AE","year":"1999","journal-title":"N Engl J Med"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/spcare-2024-004946"},{"key":"e_1_2_7_17_1","unstructured":"Voluntary Assisted Dying Review Board.Annual Report 2022\u20132023.Queensland Government.2023(cited 2026 Apr 24). Available from URL:https:\/\/www.health.qld.gov.au\/__data\/assets\/pdf_file\/0024\/1261185\/vad-annual-report-2022-23.pdf"},{"key":"#cr-split#-e_1_2_7_18_1.1","unstructured":"Australian Commission on Safety and Quality in Health Care.Communicating for Safety Standard.Sydney:Australian Commission on Safety and Quality in Health Care(updated 2026 Apr 29"},{"key":"#cr-split#-e_1_2_7_18_1.2","unstructured":"cited 2026 Apr 30). Available from URL:https:\/\/www.safetyandquality.gov.au\/standards\/nsqhs-standards\/communicating-safety-standard"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.70648","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/imj.70648","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.70648","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T03:24:42Z","timestamp":1790133882000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.70648"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":18,"alternative-id":["10.1111\/imj.70648"],"URL":"https:\/\/doi.org\/10.1111\/imj.70648","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]},"assertion":[{"value":"2026-07-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"imj.70648"}}