Mrs Juliane Samara1,2
1ACT Health and Community Services Directorate, Canberra, Australia, 2NSW Health Southern NSW Local Health District, Moruya, 2537
Biography:
Juliane Samara is a specialist palliative care nurse practitioner with over two decades of experience in aged care, oncology, and palliative care. Passionate about person-centred, compassionate practice, she supports people with life-limiting illness and their families through expert assessment, symptom management, and holistic care planning. Juliane is recognised nationally for her leadership in advancing the nurse practitioner role through research and contributing to health reform as a member of the Commonwealth Aged Care Taskforce. She continues to influence nursing policy through her involvement with the Australian College of Nurse Practitioners and the Australian Nursing and Midwifery Federation.
Abstract:
Background:
Voluntary Assisted Dying (VAD) has now been implemented across all Australian States and will commence in the Australian Capital Territory (ACT) on 3 November 2025. Each jurisdiction defines the nurse practitioner (NP) role differently. In New South Wales (NSW), NPs are limited to initiating discussions, providing information, referring to the VAD service and supporting patients within palliative care as they navigate the VAD process. In contrast, the ACT is the first jurisdiction in Australia to authorise NPs to act in all stages of the VAD pathway – as Coordinating, Consulting, and Administering Practitioners. This expanded scope represents a significant evolution in both clinical autonomy and ethical responsibility for NPs in end-of-life care.
Aim:
This presentation aims to reflect on the lived experience of a palliative care nurse practitioner who is an Authorised VAD Practitioner in the ACT, with comparative insights from NSW practice.
Methods:
Gibbs’ Reflective Cycle will guide structured reflection on practice, drawing on the NP’s reflective diary and real case studies from NSW and the ACT. The six stages – description, feelings, evaluation, analysis, conclusion and action plan – will frame exploration of professional, ethical and emotional dimensions of practice.
Results:
As ACT practice has not yet commenced, reflections will consider anticipated outcomes. These may include enhanced professional satisfaction through expanded scope, strengthened patient relationships and greater emotional and ethical complexity. The experience is expected to underscore the need for comprehensive education, supervision, and peer support to sustain practitioner wellbeing.
Conclusion:
The ACT’s inclusive VAD legislation marks a pivotal step in recognising the capability and clinical expertise of NPs. Reflective practice will be essential in shaping safe, ethical and person centred VAD and palliative care as this new model evolves.