Australian Health Professionals’ Attitudes toward Voluntary Assisted Dying: A Cross-Sectional Survey

Abstract

Voluntary assisted dying (VAD) is when a terminally ill person with decision-making capacity consensually ends their life with assistance from an authorised professional. Many countries have legalised VAD, and health professionals’ roles within VAD frameworks are varied. Health professionals must be well informed of their legal obligations to ensure they practice within the legal boundaries, and those professionals with objections toward VAD should ensure that their eligible patients have equitable access. Given the current landscape of VAD, it is important to understand different health professionals’ attitudes toward VAD and what may underpin these attitudes. We explored (a) Australian health professionals’ attitudes toward VAD; (b) the psychological components that underpin those attitudes; (c) health professionals’ level of knowledge about VAD; (d) health professionals’ most common beliefs, emotions, and experiences related to VAD. A cross-sectional correlational survey design was used. A total of 182 Australian health professionals participated in the online survey based on a tripartite model of attitudes. We conducted a binomial logistic regression through a Generalised Linear Mixed Model and found polarised attitudes toward VAD between health professionals. Attitudes were accounted for by beliefs, emotions, education, and strength of religious beliefs. Knowledge of VAD was low, but not associated with overall attitude in our model. We highlight the importance of reflexive practice to help health professionals identify their values and feelings related to VAD, and to understand how these may affect their clinical practice. Low knowledge of VAD suggests that legislative and procedural training should be mandatory.

Implementing voluntary assisted dying laws in healthcare: Exploring beliefs to identify implementation hurdles

“…The key finding in the context of implementation was that Health Widespread community support for VAD (Emanuel et al, 2016;Kresin et al, 2021) has translated into law in many jurisdictions. The practise of intentionally ending a life, however, does not garner the same level of support among those healthcare services or healthcare professionals who are ultimately responsible for operationalising these laws (Emanuel et al, 2016;Munday & Poon, 2020;O'Connor et al, 2021). This means that implementing the law may face unique challenges (Fujioka et al, 2018).…”

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

“…A systematic review of health professionals’ perspectives on AD implementation barriers and facilitators identified that personal and professional values act as both barriers and facilitators and influence how HCPs prioritise clinical issues [ 36 ]. In Australia, HCPs’ attitudes towards AD are informed by their beliefs, emotions, education, and strength of religious beliefs, but not knowledge of AD [ 37 ]. The authors of these two studies [ 36 , 37 ] advocate for more research with HCPs and stakeholders regarding ‘safeguarding’ and assessing ‘capacity’ and for HCPs’ reflexive practice about the influence of values and feelings on clinical practice [ 36 , 37 ].…”

“…In Australia, HCPs’ attitudes towards AD are informed by their beliefs, emotions, education, and strength of religious beliefs, but not knowledge of AD [ 37 ]. The authors of these two studies [ 36 , 37 ] advocate for more research with HCPs and stakeholders regarding ‘safeguarding’ and assessing ‘capacity’ and for HCPs’ reflexive practice about the influence of values and feelings on clinical practice [ 36 , 37 ]. Safety is a priority for respondents as referenced by items 1, 4 and 10 (see Table 2 ).…”

Norwegian Nurses’ Attitudes Toward Assisted Dying: A Cross-Sectional Study

“…However, a new Australian study reports that health professionals with a high level of education had a more positive attitude toward assisted dying. 24…”

“…Furthermore, experienced nurses working with terminally ill patients seem to vary more in their attitudes toward assisted dying. 24 In 2015, the Norwegian Bioethical Survey (NOBAS) conducted a population survey with a sample of 22,660 Norwegians that included questions about their attitudes toward assisted dying. 2 The bivariate analyses in the study showed that the majority of the participants agreed with legalizing assisted dying through physician-assisted suicide (73%, N = 2230) and euthanasia (66%, N = 2027).…”