Being a safe place: a qualitative study exploring perceptions as to how a rural community hospice could respond to enactment of voluntary assisted dying legislation

Abstract

Background There is a lack of research to guide the implementation of voluntary assisted dying legislation within a hospice setting. Furthermore, there is limited published information related to the expectations of the community and staff to assist decision making regarding voluntary assisted dying in a community hospice. The aim of this study was to explore the expectations of staff, volunteers and members of the community as how a rural Australian community hospice could respond in relation to imminent enactment of Voluntary Assisted Dying legislation. Methods A total of 63 Hospice staff and volunteers and community members participated in 11 workshops. This qualitative study used the interpretive description method to analyse the workshop transcripts. Results While there was not a consensus view on community expectation, there was agreement among the participants for respect for a patient’s individuality and choices. Furthermore, care offered in hospice needs to remain non-judgemental and patient focused regardless of whether voluntary assisted dying policy was implemented or not. Both opportunities and risks associated with implementation were identified by the participants. Conclusion There was common ground around the respect for the dying person and the ideal of a “safe place” despite opposing views on what this may mean in practice. There is a need for clarity in organisational responses around policy, risk management, education, and staff support.

“Respecting our patients’ choices”: Making the organizational decision to participate in voluntary assisted dying provision: Findings from semi-structured interviews with a rural community hospice board of management

“…Eleven workshops with 63 participants were conducted and the results were presented to the Board in December 2020. The workshops indicated a variety of expectations as to how ACH could respond, although there was general agreement amongst stakeholders that patient-focused care, remaining a "safe place", transparent policies and awareness of risk to the Hospice should be considered by the Board in coming to a decision [23].…”

Nurses' experiences of supporting patients requesting voluntary assisted dying: A qualitative meta‐synthesis

“…Combining VAD into palliative care services has led to new models of practice and policy at times at odds with the services' foundational philosophy (Freeman et al, 2021). These larger issues around the model of care include bringing to light previous experience of nurses to prepare and know how to support nurses who are navigating new experiences in their professional careers and workplaces, under the gaze of the community (Auret, 2022; Freeman et al, 2021).…”