Professor Michael Dooley is no stranger to death and human suffering.
The clinical pharmacist has spent years working in hospitals and helping to provide care and medication to the terminally ill.
But Dooley, who is the director of Victoria’s Voluntary Assisted Dying Statewide Pharmacy Service, says his work in the state’s voluntary assisted dying scheme has changed him.
“I’m no doubt more aware that life is something that’s so precious,” he said.
“It is amazing to see the steely-eyed determination in patients who are suffering so intolerably and have to make very difficult decisions … They’re at the end of a long journey. They just want to be able to die in a manner with dignity and at their choosing.”
Before the historic voluntary assisted dying laws came into effect in 2019, Dooley helped formulate the lethal dose of oral medication, a highly potent powdered sedative, which is mixed with a liquid medication before being consumed.
“The experience overseas at that time had been very variable,” he said.
“We had a fairly blank piece of paper to start with. We had to design a system that was going to be safe and work as intended.”
Over six years, he and a team of pharmacists, who deliver the medication to terminally ill people, gathered data on the experiences of people’s final moments from their loved ones.
The landmark research, led by Dooley and Monash University, tracked 572 Victorian cases between 2019 and 2025, making it the largest published dataset of patients who have used oral, self-administered assisted dying medications globally.
It found every patient who took the medication died after consuming it. More than 98 per cent of people successfully swallowed the small mixture in under four minutes, and about 93 per cent lost consciousness in less than 10 minutes.
Most patients (64.1 per cent) died within 30 minutes, and 86 per cent were dead within an hour.
Dooley said the study found the self-administered medication reliably led to a peaceful death without triggering potential complications, which have been associated with multi-drug combinations used in other countries.
“This research offers really important reassurance for patients, families and clinicians,” Dooley said.
“The method of oral self-administration and the medication used has now been shown to be safe and very effective.”
The findings were published in BMJ Supportive & Palliative Care, part of the prestigious British Medical Journal group.
Countries across the world, including England and Scotland, are considering their own voluntary assisted dying laws amid politically charged debates.
Dooley, who works at the Centre for Medicine Use and Safety at the Monash Institute of Pharmaceutical Sciences, said the findings cemented Victoria’s model as a world-leading benchmark for safe and effective self-administration.
“These findings should be used to inform those making decisions regarding potential access to assisted dying in various jurisdictions internationally,” he said.
Through a voluntary, anonymous feedback survey handed out by the pharmacists, families were asked questions including how long it took for the person to lose consciousness after taking the medication and if there were any difficulties with the person swallowing the mixture.
“It’s given us a unique insight into what happens when someone takes medications to end their life, what they experienced, what their families, carers and the health professionals witnessed,” Dooley said.
“That information has been critical.”
He said the most common word received in the written feedback from families was “peaceful”.
“The experience was that their loved one was peaceful in their last moments of life,” he said.
About 6.5 per cent of people took longer than two hours to die.
The longest time from consumption to death was reported in a case where a person died 11 hours after drinking the medication.
The researchers noted that human bodies naturally process drugs differently based on their underlying illnesses.
The findings suggested the medication might take slightly longer to cause death for people with neurological conditions, such as motor neurone disease (MND), than for people with terminal cancer.
This is thought to be because neurological conditions may slow the absorption of oral medications.
A “very bitter taste” after taking the medication was reported by about 10 per cent of those who took it, the findings said.
To manage this, patients can have another drink of their choice immediately after swallowing the medication to mask the bitterness.
Each week, the Victorian pharmacists, who always travel in pairs, drive across the state to drop off the medication, which is stored in a locked box.
About 40 per cent of patients who want to access assisted dying live in rural areas.
Dooley said that for healthcare clinicians working in voluntary assisted dying, the job could be challenging and emotional.
“None of us are the same because we do it,” he said.
“You walk into a home, and you see their life on display, photos of their grandchildren or them playing sports or their wedding day. You get a sense of who they are, not just as a patient in a bed, but as a person with a rich life story.”
But Dooley said it was a privilege to sit with a person and their families at the most difficult time and offer support.
“I always think you take a little bit of their lives with you when you go,” he said.
“My wife tells me I’m a better person for doing this … that I am more conscious of others and the challenges associated with life.”
Victoria’s laws allow terminally ill adults who have only six months to live and meet other strict eligibility criteria – such as being able to give informed consent – access to a lethal substance.
The most recent data showed 1683 people have used a voluntary assisted dying substance to end their lives since the laws began in 2019.
These included those who took the medication themselves and others took it intravenously with the support of a doctor.
Minister for Health Harriet Shing said Victorians who were terminally ill and living in pain deserved “dignity and choice” in how they lived out their final days.
“We were the first state to introduce voluntary assisted dying laws, and we’ve now delivered important reforms to make these laws clearer and more compassionate,” she said.
If you are troubled by this report or experiencing a personal crisis, you can call Lifeline 131 114 or Beyond Blue 1300 224 636 or visit lifeline.org.au or beyondblue.com.au
Melissa Cunningham is a health reporter for The Age. She has previously covered crime and justice.Connect via X or email.
