Medical Practitioners' Views and Experiences of Being Involved in Assisted Dying in Victoria, Australia: A Qualitative Interview Study Among Participating Doctors

Social Science & Medicine (online first version), 2021

35 Pages Posted: 21 Jan 2022

See all articles by Marcus Sellars

Marcus Sellars

Independent

Ben White

Queensland University of Technology - Faculty of Law

Patsy Yates

Queensland University of Technology

Lindy Willmott

Queensland University of Technology - Faculty of Law

Date Written: November 2021

Abstract

Rationale
On June 19, 2019, Assisted Dying (AD) was legalized in the Australian state of Victoria, joining a small but growing cohort of jurisdictions internationally where AD is permitted. Few studies have examined perspectives of doctors who have participated in AD in jurisdictions where it has become legal, despite their pivotal role in the system.

Objective
This study aimed to describe the beliefs, experiences and perspectives of doctors who had provided AD during the first 12 months of its operation in Victoria, Australia.

Method
In-depth, semi-structured interviews were conducted between April and July 2020 with 32 Victorian doctors who had been involved in the AD process during the first 12-months since it became legal in Victoria. The assumptions underpinning our methodology were guided by a phenomenological approach and reflexive thematic analysis was used to analyze the data.

Results
Five major themes were identified: a nascent approach to care, practising within clinical and legal uncertainty, confronting practices, personal sacrifices and coping amid new challenges. A thematic schema was developed, illustrating that these themes were expressed as a balance of competing tensions of identity for doctors who provided AD for their patients in practice. A major tension was not just how doctors' perceptions impacted their own wellbeing and satisfaction, but also how these challenged their continued involvement in AD and, therefore, the system's overall ability to function.

Conclusion
Our findings show that while doctors discussed AD as an ethical practice, it also involved multiple identities with varying sources of meaning, and these identities were sometimes overlapping depending on context. As other jurisdictions increasingly move to legalize AD, a greater appreciation of the different role-based and group-based challenges involved in AD may improve AD implementation strategies.

Note:
Funding Information: This research was supported by the Queensland University of Technology (Faculties of Health and Law). Ben White is a recipient of an Australian Research Council Future Fellowship (project number FT190100410: Enhancing End-of-Life Decision-Making Optimal Regulation of Voluntary Assisted Dying) funded by the Australian Government. Lindy Willmott, Ben White, and Patsy Yates have received grants from the Victorian and Western Australian governments to design and provide training required by doctors (and nurse practitioners in Western Australia) involved in voluntary assisted dying.

Declaration of Interests: LW, BPW, and PY have received grants from the Victorian and Western Australian governments to design and provide training required by doctors (and nurse practitioners in Western Australia) involved in voluntary assisted dying.

Ethics Approval Statement: Ethics approval for this research was received from [blinded for peer review] Human Research Ethics Committee (UHREC) (reference 2000000033). The study objectives and voluntary nature of the study were explained to participants, and informed consent was obtained before each interview. In addition, prior to starting the interviewer asked participants not to breach their duties of confidentiality by naming patients, family members, or other medical practitioners, and we used codes instead of names (eg, ID_01, ID_02). The interviewer removed all identifying information from the transcripts and reviewed each transcript for accuracy.

Keywords: Assisted dying, Implementation of assisted dying, Doctors' perspectives, Semi-structured interviews, End-of-life, Identity theory, Australia

JEL Classification: I00, I10, I19, K00, K10, K19, K32, K39

Suggested Citation

Sellars, Marcus and White, Ben and Yates, Patsy and Willmott, Lindy, Medical Practitioners' Views and Experiences of Being Involved in Assisted Dying in Victoria, Australia: A Qualitative Interview Study Among Participating Doctors (November 2021). Social Science & Medicine (online first version), 2021, Available at SSRN: https://ssrn.com/abstract=3969557

Marcus Sellars

Independent ( email )

Ben White (Contact Author)

Queensland University of Technology - Faculty of Law ( email )

Level 4, C Block Gardens Point
2 George St
Brisbane, QLD 4000
Australia

HOME PAGE: http://staff.qut.edu.au/staff/whiteb/

Patsy Yates

Queensland University of Technology ( email )

2 George Street
Brisbane, Queensland 4000
Australia

Lindy Willmott

Queensland University of Technology - Faculty of Law ( email )

Level 4, C Block Gardens Point
2 George St
Brisbane, QLD 4000
Australia

HOME PAGE: http://staff.qut.edu.au/staff/willmott/

Do you have negative results from your research you’d like to share?

Paper statistics

Downloads
38
Abstract Views
312
PlumX Metrics