“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

Auret, Kirsten; Pikora, Terri; Gersbach, Kate; Donovan, Robert J.

doi:10.1186/s12904-022-01051-x

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…Experiences elsewhere of implementing AD indicates that AD service provision often “matures” over time as health care providers’ attitudes evolve and systems and processes are established, embedded and improved [ 28 – 30 ]. Similarly in this study, participants reflected how their response to AD is evolving with experience.…”

Section: Discussionmentioning

confidence: 99%

Health care providers’ early experiences of assisted dying in Aotearoa New Zealand: an evolving clinical service

et al. 2023

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Background In November 2021, assisted dying (AD) became lawful in Aotearoa New Zealand. A terminally ill person may now request, and receive, pharmacological assistance (self-administered or provided by a medical practitioner/nurse practitioner) to end their life, subject to specific legal criteria and processes. Exploring the experiences of health providers in the initial stage of the implementation of the End of Life Choice Act 2019 is vital to inform the ongoing development of safe and effective AD practice, policy and law. Aim To explore the early experiences of health care providers (HCPs) who do and do not provide AD services seven months after legalisation of AD to provide the first empirical account of how the AD service is operating in New Zealand’s distinctive healthcare environment and cultural context. Design Qualitative exploratory design using semi-structured individual and focus group interviewing with a range of HCPs. Results Twenty-six HCPs participated in the study. Through a process of thematic analysis four key themes were identified: (1) Difference in organisational response to AD; (2) challenges in applying the law; (3) experiences at the coal face; and (4) functionality of the AD system. Conclusion A range of barriers and enablers to successful implementation of AD were described. Adoption of open and transparent organisational policies, ongoing education of the workforce, and measures to reduce stigma associated with AD are necessary to facilitate high quality AD service provision. Future research into the factors that influence responses to, and experience of AD; the impact of institutional objection; and the extent to which HCP perspectives evolve over time would be beneficial. In addition, further research into the integration of AD within Māori health organisations is required.

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Section: Discussionmentioning

confidence: 99%

Health care providers’ early experiences of assisted dying in Aotearoa New Zealand: an evolving clinical service

et al. 2023

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"People aren’t happy to see refugees coming to Switzerland. They don’t like assisted suicide for foreigners": Organizations’ perspectives regarding the right-to-die and suicide tourism

Sperling

2024

Death Studies

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Still safe; still respectful: a mixed methods study exploring the early experiences of a rural community hospice in providing voluntary assisted dying

Auret,

Pikora,

Briand

2024

Preprint

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Background Voluntary assisted dying has become available as an end-of-life choice in many countries, including Australia. There is evidence on the mixed impact of voluntary assisted dying legislation on palliative care healthcare professionals, however, less is known about the interface between palliative care and voluntary assisted dying in smaller rural settings. This study explored the experiences of staff at a hospice in rural Western Australia in the two years following the implementation of voluntary assisted dying legislation. Methods A mixed-methods research methodology was used, with data collected via a brief anonymous survey and semi-structured interviews conducted with hospice staff in one rural location in Western Australia. Survey data was exported into SPSS and descriptive statistics were performed. Interviews were audio recorded and after deidentification, the transcripts were analysed thematically. Results A total of 30 participants took part in the survey and 10 were interviewed. The majority (n = 19) of survey respondents had been involved in voluntary assisted dying, yet only seven reported that their day-to-day role had changed. Supporting patient choice and autonomy were the most cited benefits of the introduction of voluntary assisted dying. Analysis of the qualitative data yielded three main themes: everyone is involved with patients accessing VAD; nothing changes but everything changes; and perceived support, education and training needs. Conclusions This study has described day-to-day work and experiences of those working in a small rural hospice which has integrated VAD into the care offered within the facility, observing there are subtle changes in the organisational atmosphere when VAD occurs. The education and support activities in place and the noted gaps may be a useful checklist for other hospices in the early phases of integrating VAD into their facility. Recommendations for future research are made.

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“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

Cited by 3 publications

References 27 publications

Health care providers’ early experiences of assisted dying in Aotearoa New Zealand: an evolving clinical service

Health care providers’ early experiences of assisted dying in Aotearoa New Zealand: an evolving clinical service

"People aren’t happy to see refugees coming to Switzerland. They don’t like assisted suicide for foreigners": Organizations’ perspectives regarding the right-to-die and suicide tourism

Still safe; still respectful: a mixed methods study exploring the early experiences of a rural community hospice in providing voluntary assisted dying

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