Restricting Conversations About Voluntary Assisted Dying: Implications for Clinical Practice

BMJ Supportive and Palliative Care, 2019, 10(1), pp. 105-110.

13 Pages Posted: 2 Oct 2019 Last revised: 20 Jul 2020

See all articles by Ben White

Ben White

Queensland University of Technology - Faculty of Law

Lindy Willmott

Queensland University of Technology - Faculty of Law

Danielle Ko

Austin Health

James Downar

affiliation not provided to SSRN

Luc Deliens

Vrije Universiteit Brussel (VUB)

Date Written: August 15, 2019

Abstract

Objectives: On 19 June 2019, assisted dying became lawful in Victoria, the second most populous state in Australia. Section 8 of the Voluntary Assisted Dying Act is a legislative safeguard that is designed to ensure a patient’s request for assistance to die is voluntary. This section prohibits health practitioners from initiating a conversation about assisted dying with the patient. This article explores the potential implications of this prohibition for effective communication between doctors and their patients, and the ability of doctors to provide high quality end-of-life (EOL) care in some cases.

Method: The authors reviewed and analysed literature on the importance of communication at the EOL including the need to understand and appropriately respond to Desire to Die or Desire to Hasten Death statements. A legal critique of section 8 of the Victorian Voluntary Assisted Dying Act was also undertaken to determine the scope of this new duty and how it aligns with existing legal obligations that would otherwise require doctors to provide information about EOL options requested by a patient.

Results: Contemporary literature suggests that open and honest communication between doctor and patient including the provision of information about all EOL options when sought by the patient represents good clinical practice and will lead to optimal EOL care. The provision of such information also reflects professional, ethical and legal norms.

Conclusion: Despite (arguably) promoting an appropriate policy objective, the legislative prohibition on health professionals initiating conversations about voluntary assisted dying may, in cases where patients seek information about all EOL options, lead to less optimal patient outcomes.

Keywords: assisted dying, end of life, end of life communication

JEL Classification: I1, K32

Suggested Citation

White, Ben and Willmott, Lindy and Ko, Danielle and Downar, James and Deliens, Luc, Restricting Conversations About Voluntary Assisted Dying: Implications for Clinical Practice (August 15, 2019). BMJ Supportive and Palliative Care, 2019, 10(1), pp. 105-110. , Available at SSRN: https://ssrn.com/abstract=3452306

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/

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/

Danielle Ko

Austin Health

145 Studley Rd
Heidelberg VIC 3084, Melbourne
Australia

James Downar

affiliation not provided to SSRN

Luc Deliens

Vrije Universiteit Brussel (VUB) ( email )

Pleinlaan 2
http://www.vub.ac.be/
Brussels, 1050
Belgium

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