How should palliative care respond to increasing legislation for assisted dying?

Preston, Nancy

doi:10.1177/0269216319848223

Cited by 12 publications

(10 citation statements)

References 11 publications

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“…28 Comprehensive palliative care may alleviate physical symptoms and provide psychosocial and spiritual care and must always be available to patients considering VAD. 13,28,39 In this study, themes of conflict and emotional burden emerged. It has been reported in previous research that the effect of witnessing VAD or caring for patients taking this option has had a profound effect on some clinicians, ranging from intense professional fulfillment and reward 8,9 through the whole spectrum of emotions to moral distress 9,40 and concern for the wider implications for society in general.…”

Section: Discussionmentioning

confidence: 67%

Introducing Voluntary Assisted Dying: Staff Perspectives in an Acute Hospital

Digby

McDougall

Gold

et al. 2020

Int J Health Policy Manag

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Background: Voluntary assisted dying (VAD) was legalised in Victoria, Australia in June 2019. Physicians can now assist patients to end their lives by providing drugs for self-administration at their voluntary and competent request (or for physician administration in limited circumstances). This study investigates the opinions of clinicians on the implementation of the legislation in one Victorian hospital. Methods: This exploratory survey study was conducted at a 600-bed acute hospital in Melbourne, Australia in Jan 2019. 382 clinicians completed one or more qualitative questions. Participants commented on VAD, potential workplace challenges and staff support required. Free-text responses were analysed using inductive content analysis. Results: Six themes: (1) Polarised views; (2) Fear of conflict; (3) Emotional burden; (4) Vulnerable patients; (5) Organisational challenges; (6) Decision-making. There were diverse views including objections to VAD for religious or ethical reasons, and whole-hearted support based on a compassionate response to suffering and the right of patients to self-determination. Participants feared conflict between colleagues, families and patients, and aggression towards staff. Clinicians called for educational and psychological support. There was concern that vulnerable patients may be coerced to opt for VAD to lessen the burden on families or the health system. Clinicians feared workloads would increase with the introduction of VAD. Patient decision-making capacity in this context must be firmly established before proceeding, and thorough assessments for depression, and optimal symptom management must be implemented before VAD is approved. A dedicated VAD team was suggested to support staff and manage VAD patients. Conclusion: Participants expressed polarised opinions about VAD and showed considerable anxiety about its introduction. Additional education and support are required to ensure that clinicians understand details of the legislation and their professional and personal options. Tolerance and respect for alternative viewpoints must be advocated within the organisation and more broadly.

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Section: Discussionmentioning

confidence: 67%

Introducing Voluntary Assisted Dying: Staff Perspectives in an Acute Hospital

Digby

McDougall

Gold

et al. 2020

Int J Health Policy Manag

View full text Add to dashboard Cite

show abstract

“…The challenge of incorporating human rights in palliative care research is apparent and such an approach will not be applicable in every instance. There must, of course, be (1) a suitable environment in which greater engagement with human rights can be advanced. For this to be achieved, healthcare professionals should take account of factors such as education and training, interdisciplinary connections, recognition of the scope of human rights and the influence of rights-holders as set out below.…”

Section: Developing the Voice At The Tablementioning

confidence: 99%

“…In the June 2019 edition of Palliative Medicine , Nancy Preston contributed an editorial titled ‘How should palliative care respond to increasing legislation for assisted dying?’ In this she stated that ‘Palliative care clinicians and researchers tend to react to media coverage of public stories and increasingly parliamentary debates, rather than proactively shaping the debates’. 1 The editorial closed with the line, ‘Palliative care needs a voice at the table’. 1 This leaves open the question of how that voice is to be effectively developed, captured and disseminated.…”

mentioning

confidence: 99%

“…1 The editorial closed with the line, ‘Palliative care needs a voice at the table’. 1 This leaves open the question of how that voice is to be effectively developed, captured and disseminated. In this editorial, it is argued that the answer lies in much closer and deeper engagement from the palliative care community with law, particularly the area of human rights, at a local and national level.…”

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confidence: 99%

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Bridging the divide between law and palliative medicine

Lombard

2020

Palliat Med

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“…We only refer to the increase in criminal legislation, i.e., laws that establish penalties, not to the increase in decriminalising legislation as some refer to it and not the other way around, i.e., the increase in laws that decriminalise conduct (Preston 2019), which could, in any case, be considered as a sub-topic of an investigation into increases in criminal legislation (but will not be dealt with here).…”

Section: Introductionmentioning

confidence: 99%

When Is an Increase in Criminal Legislation Necessary? Emphasis on Economic Criminality Discussions

Jiménez

2021

Laws

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The objective of this article is to answer the question of when an increase in criminal legislation is necessary. To this end, a review was conducted on the positions that deal directly or peripherally with increases in criminal legislation, with a focus on how these positions relate to increases, such as the more general positions related to “law and social change”, as well as the more specific positions related to penal inflation and “penal populism”. Special reference will be made to the expansion thesis, which, in general, has been well received in Ibero-America. In the second section of this study, the answer to the question is addressed, considering elements from the “law and social change” approach and Sutherland’s reflections on white-collar criminality.

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How should palliative care respond to increasing legislation for assisted dying?

Cited by 12 publications

References 11 publications

Introducing Voluntary Assisted Dying: Staff Perspectives in an Acute Hospital

Introducing Voluntary Assisted Dying: Staff Perspectives in an Acute Hospital

Bridging the divide between law and palliative medicine

When Is an Increase in Criminal Legislation Necessary? Emphasis on Economic Criminality Discussions

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