Implementing assisted dying in rural and remote Australia and comparable jurisdictions: A scoping review

Assisted dying presents unique challenges in rural and remote communities, where geographic isolation, cultural norms, and service limitations shape access and experience. This scoping review synthesized peer-reviewed and grey literature from Australia and comparable jurisdictions (primarily Canada, one study from India) identifying key themes relating to assisted dying implementation in rural and remote contexts. Five themes emerged: legislative and policy frameworks; cultural, social, and ethical considerations; access and equity in service provision; healthcare provider roles and experiences; and family and community impact. Findings highlight how restrictive telehealth laws, provider scarcity, and administrative burden disproportionately affect rural and remote patients. Cultural and institutional dynamics influence acceptance, while families face emotional, logistical, and social pressures. Innovative models such as nurse practitioner inclusion, care navigation, and culturally safe outreach offer potential solutions. Assisted dying is not merely a clinical procedure but a socially embedded practice. Equitable access requires coordinated legal, relational, and infrastructural reforms.