Assisted dying. Reflections on the need for law reform

Much has been written about whether end-of-life law should change and what that law should be. However, the barriers and facilitators of such changes – law reform perspectives – have been virtually ignored. Why do so many attempts to change the law fail but others are successful? International Perspectives on End-of-Life Law Reform aims to address this question by drawing on ten case studies of end-of-life law reform from the United Kingdom, the United States, Canada, the Netherlands, Belgium and Australia. Written by leading end-of-life scholars, the book's chapters blend perspectives from law, medicine, bioethics and sociology to examine sustained reform efforts to permit assisted dying and change the law about withholding and withdrawing life-sustaining treatment. Findings from this book shed light not only on changing end-of-life law, but provide insight more generally into how and why law reform succeeds in complex and controversial social policy areas.

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Drawing a Line between Killing and Letting Die: The Law, and Law Reform, on Medically Assisted Dying

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.1993.tb01234.x ◽

1993 ◽

Vol 21 (1) ◽

pp. 94-101 ◽

Cited By ~ 15

Author(s):

Lawrence O. Gostin

Keyword(s):

Medical Ethics ◽

Civil Liability ◽

Law Reform ◽

Assisted Dying ◽

Competent Patient ◽

Sharp Distinction ◽

Lethal Injection ◽

Life Sustaining Treatment ◽

Killing And Letting Die ◽

Constitutional Right

Traditional medical ethics and law draw a sharp distinction between allowing a patient to die and helping her die. Withholding or withdrawing life sustaining treatment, such as by abating technological nutrition, hydration or respiration, will cause death as surely as a lethal injection. The former, however, is a constitutional right for a competent or once-competent patient, while the latter poses a risk of serious criminal or civil liability for the physician, even if the patient requests it.

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Physician attitudes to voluntary assisted dying: a scoping review

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2020-002192 ◽

2020 ◽

pp. bmjspcare-2020-002192

Author(s):

Jodhi Rutherford ◽

Lindy Willmott ◽

Ben P White

Keyword(s):

Thematic Analysis ◽

Scoping Review ◽

Social Impact ◽

Physician Attitudes ◽

Law Reform ◽

Assisted Dying ◽

Willingness To Participate ◽

Eligibility Criteria ◽

Personal Impact ◽

Australian State

BackgroundVoluntary assisted dying (VAD) became legal in the Australian state of Victoria on 19 June 2019 and will be legal in Western Australia from 2021. Other Australian states are progressing similar law reform processes. In Australia and internationally, doctors are central to the operation of all legal VAD regimes. It is broadly accepted that doctors, as a profession, are less in favour of VAD law reform than the rest of the community. To date, there has been little analysis of the factors that motivate doctors’ support or opposition to legalised VAD in Australia.AimTo review all studies reporting the attitudes of Australian doctors regarding the legalisation of VAD, including their willingness to participate in it, and to observe and record common themes in existing attitudinal data.DesignScoping review and thematic analysis of qualitative and quantitative data.Data sourcesCINAHL, Embase, Scopus, PubMed and Informit were searched from inception to June 2019.Results26 publications detailing 19 studies were identified. Thematic analysis of quantitative and qualitative findings was performed. Three overarching themes emerged. ‘Attitudes towards regulation’ encompassed doctors’ orientation towards legalisation, the shortcomings of binary categories of support or opposition and doctors’ concerns about additional regulation of their professional practices. ‘Professional and personal impact of legalisation’ described tensions between palliative care and VAD, and the emotional and social impact of being providers of VAD. ‘Practical considerations regarding access’ considered doctors’ concerns about eligibility criteria and their willingness to provide VAD.ConclusionA detailed understanding of medical perspectives about VAD would facilitate the design of legislative models that take better account of doctors’ concerns. This may facilitate their greater participation in VAD and help address potential access issues arising from availability of willing doctors.

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Voluntary assisted dying law reform in Australia and New Zealand

Routledge Handbook of Global Health Rights ◽

10.4324/9780429297021-25 ◽

2021 ◽

pp. 348-366

Author(s):

Ian Freckelton

Keyword(s):

New Zealand ◽

Law Reform ◽

Assisted Dying

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Future of assisted dying reform in Australia

Australian Health Review ◽

10.1071/ah18199 ◽

2018 ◽

Vol 42 (6) ◽

pp. 616 ◽

Cited By ~ 6

Author(s):

Ben White ◽

Lindy Willmott

Keyword(s):

Social Science ◽

Law Reform ◽

Political Environment ◽

Reform Process ◽

Assisted Dying ◽

Key Factors ◽

Different Types ◽

Social Science Evidence ◽

Health Administrators ◽

Science Evidence

The Voluntary Assisted Dying Act 2017 (Vic) will come into force in June 2019, becoming the first law in Australia in 20 years to permit voluntary assisted dying (VAD). This paper considers how other Australian states and territories are likely to respond to this development. It analyses three key factors that suggest that law reform is likely to occur in other parts of Australia: (1) the growing international trend to permit VAD; (2) social science evidence about how VAD regimes operate; and (3) changes to the local political environment. The paper argues that these three factors, coupled with the effect of Victoria changing its law, suggest that other VAD law reform is likely to occur in Australia. It also considers the different types of laws that may be adopted, including whether other states and territories will follow the very conservative Victorian approach or adopt more liberal models. What is known about the topic? Despite sustained law reform efforts in parliaments across the country, Victoria is the first Australian jurisdiction to pass a law permitting VAD in 20 years. What does this paper add? This paper addresses likely future trends in VAD law reform in Australia. Drawing on international developments, a growing body of social science evidence about how VAD regimes work in practice, and evidence about a changing local political environment, the paper argues that other states and territories in Australia will also enact laws about VAD. What are the implications for practitioners? The legalisation of VAD has significant implications for health professionals, health administrators and health systems. Understanding how reform may occur and what legal models may be considered supports participation in the law reform process and preparation for likely change.

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