Perspectives of cancer treatment providers regarding voluntary assisted dying in Victoria

Yoong, Jaclyn; Franco, Michael; William, Leeroy; Poon, Peter

doi:10.1111/imj.13939

Cited by 13 publications

(13 citation statements)

References 9 publications

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“…In this study, there was an almost even split between those reporting a positive attitude toward VAD and those reporting negative attitudes. This finding is consistent with recent Australian findings that health professionals working in the field of oncology failed to reach a clear consensus on VAD (Karapetis et al 2018;Yoong et al 2018), and international studies finding that health professionals hold diverse attitudes towards VAD (Young et al 1993). Together this indicates polarised views on the topic.…”

Section: Discussionsupporting

confidence: 90%

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

et al. 2021

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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.

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Section: Discussionsupporting

confidence: 90%

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

et al. 2021

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“…In 2017, a survey conducted at a single Victorian institution showed that clinicians were divided on whether they supported VAD (28% support vs 28% opposed), with 44% being uncertain. 10 Similarly, a 2018 survey by the Medical Oncology Group of Australia similarly identified that 46% of members disagreed with VAD, 36% agreed and 17% were neutral on VAD. 11 The authors from both studies acknowledge their limited small sample sizes.…”

Section: Introductionmentioning

confidence: 99%

Support for and willingness to be involved in voluntary assisted dying: a multisite, cross‐sectional survey study of clinicians in Victoria, Australia

Sellars

Tacey

McDougall

et al. 2021

Internal Medicine Journal

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Background: In the Australian state of Victoria, specialist doctors are central to the operation of voluntary assisted dying (VAD). However, a broad range of clinicians may be involved in the care of patients requesting or using VAD.Aims: To describe levels of support for and willingness to be involved in VAD and consider factors associated with clinician support for the VAD legislation and physicians' willingness to provide VAD in practice.Methods: A multisite, cross-sectional survey of clinicians in seven Victorian hospitals.All clinicians were invited to complete an online survey measuring demographic characteristics, awareness of and support for the VAD legislation, willingness to participate in VAD related activities and reasons for willingness or unwillingness to participate in VAD.Results: Of 5690 who opened the survey, 5159 (90.1%) were included in the final sample and 73% (n = 3768) supported the VAD legislation. The strongest predictor of support for the VAD legislation was clinical role. Forty percent (n = 238) of medical specialists indicated they would be willing to participate in either the VAD consulting or coordinating role. Doctors did not differ in willingness between high impact (44%) and low impact specialty (41%); however, doctors specialising in palliative care or geriatric medicine were significantly less willing to participate (27%). Conclusion:Approximately 73% of surveyed staff supported Victoria's VAD legislation. However, only a minority of medical specialists reported willingness to participate in VAD, suggesting potential access issues for patients requesting VAD in accordance with the legal requirements in Victoria.

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“…4 Consequently there is limited local data available to inform hospital approaches to implementation despite the shared goal of reducing suffering and providing good dying experiences for patients. 3,5,6 The experiences of clinicians in other jurisdictions have been mixed, with some experiencing considerable difficulties in working relationships, [7][8][9] whilst others found that relationships with colleagues could also be strengthened 7 . For some there was a lack of clarity in their role and scope of practice.…”

Section: Introductionmentioning

confidence: 99%

Introducing Voluntary Assisted Dying: Staff Perspectives in an Acute Hospital

Digby

McDougall

Gold

et al. 2020

Int J Health Policy Manag

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Background: Voluntary assisted dying (VAD) was legalised in Victoria, Australia in June 2019. Physicians can now assist patients to end their lives by providing drugs for self-administration at their voluntary and competent request (or for physician administration in limited circumstances). This study investigates the opinions of clinicians on the implementation of the legislation in one Victorian hospital. Methods: This exploratory survey study was conducted at a 600-bed acute hospital in Melbourne, Australia in Jan 2019. 382 clinicians completed one or more qualitative questions. Participants commented on VAD, potential workplace challenges and staff support required. Free-text responses were analysed using inductive content analysis. Results: Six themes: (1) Polarised views; (2) Fear of conflict; (3) Emotional burden; (4) Vulnerable patients; (5) Organisational challenges; (6) Decision-making. There were diverse views including objections to VAD for religious or ethical reasons, and whole-hearted support based on a compassionate response to suffering and the right of patients to self-determination. Participants feared conflict between colleagues, families and patients, and aggression towards staff. Clinicians called for educational and psychological support. There was concern that vulnerable patients may be coerced to opt for VAD to lessen the burden on families or the health system. Clinicians feared workloads would increase with the introduction of VAD. Patient decision-making capacity in this context must be firmly established before proceeding, and thorough assessments for depression, and optimal symptom management must be implemented before VAD is approved. A dedicated VAD team was suggested to support staff and manage VAD patients. Conclusion: Participants expressed polarised opinions about VAD and showed considerable anxiety about its introduction. Additional education and support are required to ensure that clinicians understand details of the legislation and their professional and personal options. Tolerance and respect for alternative viewpoints must be advocated within the organisation and more broadly.

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Perspectives of cancer treatment providers regarding voluntary assisted dying in Victoria

Cited by 13 publications

References 9 publications

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

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

Support for and willingness to be involved in voluntary assisted dying: a multisite, cross‐sectional survey study of clinicians in Victoria, Australia

Introducing Voluntary Assisted Dying: Staff Perspectives in an Acute Hospital

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