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Readiness of system key to End of Life Choice Act rollout
Readiness of system key to End of Life Choice Act rollout
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Research led by Dr Jessica Young from Te Herenga Waka—Victoria University of Wellington has examined critical challenges that will emerge as the End of Life Choice Act comes into effect on 7 November.
The End of Life Choice Act legalises assisted dying for adults with terminal illnesses who meet specific criteria. The Act gives those people the option of lawfully requesting medical assistance to end their lives and establishes a legal process for assisting eligible persons who exercise that option.
Dr Young says implementation of the Act is likely to create challenges for the health system.
“Once the Act comes into effect, a number of people are likely to want to have conversations about assisted dying. It is important to think about how ready all healthcare practitioners are to have these conversations, whether they intend on providing assisted dying or not,” she says.
The critical challenges researchers have identified include the need to train all healthcare practitioners in managing conversations around assisted dying, as well as cultural safety, and the delivery of assisted dying in practice.
“Attending medical practitioners will be involved in assessing requests for assisted dying, and this will include making sure that that the requestor understands that alternative options to end-of-life care are available,” says Dr Young.
“The practitioner will also have to determine that the requestor is doing so free from pressure, and aware that they can change their mind at any time. Ensuring that our medical community feels ready to navigate these challenging conversations is key.”
The Law clearly states that health practitioners cannot raise the topic of assisted dying with patients.
Dr Young would like to see further measures taken to raise public awareness that they must make an explicit request for assisted dying.
She says transparency in recording and reporting data will be crucial as it will go a long way in building public confidence and trust in the system. “Recording data accurately and monitoring adherence to safeguards will also enable us to protect vulnerable populations,” explains Dr Young.
“What are the reasons that lead people to choose assisted dying? Are people able to access the system appropriately? Who is the system not working for, and why is that the case? These are some of the questions we will need insights into, to identify how we can improve overall health-service delivery.
“The general public will be keen to understand the number of assisted deaths, and its proportion as a percentage of all deaths, as well as qualitative insights about how the systems operates in practice for patients, families and health professionals.”
She says recording qualitative insights will also help build understanding of any additional support that health practitioners require.
The recent publication on the proposed implementation and research agenda related to the End of Life Choice Act, authored by Dr Young and her research group, can be found here.