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Assisted Dying and Palliative Care

Palliative Care Australia (PCA) has today released two documents looking at the impact of assisted dying on palliative care services in countries where it is legal.

PCA Board Chair Dr Jane Fischer says the first report Reflections and Learnings – Assisted dying in Canada and the United States was written following a PCA delegation visit to Canada and the US in October.

The delegation met with a range of palliative care services, hospitals, peak bodies, government organisations and medical colleges to hear what the impact of the introduction of assisted dying has been on palliative care services and health professionals.

They heard the challenges from both a practical and ethical perspective two years since the introduction of Medical Assistance in Dying (MAID) in Canada and physician assisted dying in the US states of California and Oregon.

The key messages they heard centred on the importance of respect and dialogue in the health sector and the need for formal support and training programs for health professionals, even if they are not involved with assisted dying procedures.

This report will inform PCA’s work on how Australia’s palliative care sector and the health community more broadly will need to be supported when voluntary assisted dying is implemented in Victoria in June 2019. PCA is currently reviewing its position statement on euthanasia and physician assisted dying and will look to develop an ethical framework for health professionals in early 2019.

The second report Experience internationally of the legalisation of assisted dying on the palliative care sector written by Aspex Consulting was commissioned by PCA to look at the literature and research surrounding the intersection of palliative care and assisted dying.

The literature review supports the view that workforce capability and support need to be a high priority for governments and health services where assisted dying is legal. There needs to be a focus on the competence of the health professionals involved, not just their compliance with the legal requirements.

It is vital that governments across Australia ensure that their palliative care services can support all of those who require care at the end of life, so those people have a real choice in states where voluntary assisted dying is becoming legal. Regardless of the legality of voluntary assisted dying, palliative care and aged care services will continue to care for the vast majority of Australians at the end of life. This needs to be resourced accordingly.

Both reports also found that it is integral that patient-centred care is not lost in a health care environment where assisted dying is legal, but health professionals or the service as a whole conscientiously object.