Perspectives on organ donation: a survey of Australian voluntary assisted dying practitioners

Voluntary assisted dying (VAD) is an evolving area of end-of-life care in Australia. Internationally, over 300 individuals have donated organs after accessing VAD.

To explore Australian VAD clinicians' attitudes, knowledge and experiences regarding organ and tissue donation and to identify barriers and enablers to integrating donation into VAD practice.

We conducted a cross-sectional, mixed-methods online survey from September 2024 to April 2025 across Victoria, New South Wales, Queensland and South Australia. Participants included 244 health professionals involved in VAD care -- coordinating and consulting practitioners, nurses, and support staff -- recruited via state-based VAD navigation services, professional networks and registries.

Respondents represented ~23% of the VAD workforce in the participating states. Most supported organ (98%) and tissue (98%) donation, with 91% personally willing to donate. Only 39% had received prior donation training, and 37% were aware of existing donation-after-VAD guidelines. While 90% agreed donation should be discussed when clinically appropriate, only 63% supported routinely raising the topic in VAD contexts. Key barriers included limited training, time constraints, ethical concerns (e.g. coercion, conflicts of interest) and assumptions about donation feasibility. Most respondents (84%) expressed interest in further education, particularly on eligibility criteria and navigating donation conversations.

Australian VAD clinicians strongly support organ and tissue donation but face significant knowledge, logistical and ethical challenges. Targeted education, clear clinical guidance, structural supports and the development of national guidelines bridging both VAD and organ donation sectors are essential to ensure safe, ethical and patient-centred donation practices.