Voluntary assisted dying: impacts on health professionals.

Geetanjali Tanji Lamba, Camille LaBrooy, Sophie Lewis, Ian Olver, Alexander Holmes, Cameron Stewart, Paul Komesaroff
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Abstract

Objective The introduction and implementation of voluntary assisted dying (VAD) legislation represents a major shift in Australian health policy. Given potential repercussions for health professionals, understanding how they are being affected by this legislation is important to guide future policy and legislative changes. This study aims to explore the perspectives and experiences of Australian health professionals on VAD and compare impacts on those working under different state legislation in Victoria and WA. Methods Data were collected using a cross-sectional survey design, targeting health professionals nationally, primarily doctors and nurses. The survey had closed and open-ended response options, was informed by previous publications and was piloted prior to further roll-out. Recruitment was via professional networks and social media. Quantitative data were descriptively analysed and qualitative data were coded using NVivo and thematically analysed. Results There was a final sample size of 223. Impacts on clinicians identified include inadequate remuneration, a need for ongoing support and the recognition of barriers to mandatory training. Conclusions Impacts on health practitioners, if not addressed, have future implications for workforce sustainability. Increasing numbers of trained VAD practitioners may enable distribution of clinical load and prevent burnout. VAD practitioners are not being appropriately remunerated, which could be addressed by introducing dedicated Medicare Benefits Schedule items for VAD. Attention should also be given to incentivising training, including continuing professional development accreditation and appropriate funding. Strategies to support staff could include debriefing, mentoring, peer support and psychological consultations.

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自愿协助死亡:对医疗专业人员的影响。
目标自愿协助死亡(VAD)立法的引入和实施代表着澳大利亚医疗政策的重大转变。考虑到对医疗专业人员的潜在影响,了解他们如何受到该立法的影响对于指导未来的政策和立法改革非常重要。本研究旨在探讨澳大利亚医疗卫生专业人员对 VAD 的看法和经验,并比较在维多利亚州和西澳大利亚州不同州立法下工作的医疗卫生专业人员所受的影响。方法采用横断面调查设计收集数据,调查对象为全国范围内的医疗卫生专业人员,主要是医生和护士。调查有封闭式和开放式两种回答方式,参考了以前的出版物,并在进一步推广之前进行了试点。调查通过专业网络和社交媒体进行招募。对定量数据进行了描述性分析,对定性数据使用 NVivo 进行了编码和主题分析。对临床医生造成的影响包括薪酬不足、需要持续支持以及认识到强制性培训的障碍。增加训练有素的 VAD 从业人员数量可以分担临床负荷,防止职业倦怠。目前对 VAD 从业人员的报酬并不适当,可通过为 VAD 引入专门的医疗保险福利表项目来解决这一问题。还应重视激励培训,包括持续专业发展认证和适当的资金。支持员工的策略可包括汇报、指导、同伴支持和心理咨询。
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