What do health care professionals want to know about assisted dying? Setting the research agenda in New Zealand

Abstract

Background New Zealand recently introduced law permitting terminally ill people to request and receive assisted dying (AD) in specified circumstances. Given the nature and complexity of this new health service, research is vital to determine how AD is operating in practice. Objective To identify research priorities regarding the implementation and delivery of AD in New Zealand. Methods Using an adapted research prioritisation methodology, the researchers identified 15 potential AD research topics. A mixed-methods survey of health professionals was undertaken where respondents were asked to rate the 15 topics according to the relative importance for research to be conducted on each issue. Respondents could also suggest additional research areas, and were invited to participate in a follow-up interview. Results One hundred and nineteen respondents completed the survey. 31% had some experience with AD. The highest rated research topic was the ‘effectiveness of safeguards in the Act to protect people’; the lowest rated topic was research into the ‘experiences of non-provider (e.g., administrative, cleaning) staff where assisted dying is being provided’. Respondents suggested 49 other research topics. Twenty-six interviews were conducted. Thematic analysis of interview data and open-ended survey questions was undertaken. Six research themes were identified: general factors related to the wider health system; the experiences of health care providers at the bedside; medico-legal issues; the impact of AD; experiences on the day of dying; and the overall effectiveness of the AD system. Key issues for stakeholders included safety of the AD service; ensuring access to AD; achieving equity for ‘structurally disadvantaged’ groups; and ensuring the well-being of patients, families/whānau, providers and non-providers. Conclusions Based on early experiences of the implementation of the AD service, health professionals provide important insights into what research should be prioritised post-legalisation of AD. These findings can be used to shape the research agenda so that research may inform law, policy and best practice.

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

“…An exploratory qualitative study design was adopted. Participants were recruited through a survey conducted to identify research priorities regarding the implementation and delivery of AD in New Zealand [ 14 ]. At the end of the survey participants were invited to participate in a one-on-one interview to explore their experiences of AD.…”

Pharmacists’ Attitudes towards Medically Assisted Dying

“…Continuing education to facilitate the communication skills required for responding to requests, ensuring safe access to the service, and reducing cultural, societal, and existential issues could be considered. Further education around equity and the response of indigenous populations and their views could also be considered [33].…”

A meta‐synthesis exploring nurses' experiences of assisted dying and participation decision‐making

“…This is an essential consideration for those involved in the associated policy development to work towards creating a workplace that fosters inclusivity and support in decision-making. Since the completion of this metasynthesis, a study conducted by Young et al (2023), has explored what NZ health professionals want to know about Assisted dying; this insightful research, in conjunction with this meta-synthesis, could offer the evidence required to create policy change and positively influence workplace guidelines to create a more supportive and inclusive work environment. Such inclusive policies or practice guidelines could include contact or referral information for emotional support, which this meta-synthesis demonstrated was important for nurses; educational opportunities could also be created to ensure staff are not ill-prepared and potentially vulnerable to moral distress when faced with AD.…”