Being a safe place: a qualitative study exploring perceptions as to how a rural community hospice could respond to enactment of voluntary assisted dying legislation

Kirsten Auret,Terri Pikora,Kate Gersbach

doi:10.1186/s12904-021-00891-3

Abstract

BackgroundThere is a lack of research to guide the implementation of voluntary assisted dying legislation within a hospice setting. Furthermore, there is limited published information related to the expectations of the community and staff to assist decision making regarding voluntary assisted dying in a community hospice. The aim of this study was to explore the expectations of staff, volunteers and members of the community as how a rural Australian community hospice could respond in relation to imminent enactment of Voluntary Assisted Dying legislation.MethodsA total of 63 Hospice staff and volunteers and community members participated in 11 workshops. This qualitative study used the interpretive description method to analyse the workshop transcripts.ResultsWhile there was not a consensus view on community expectation, there was agreement among the participants for respect for a patient’s individuality and choices. Furthermore, care offered in hospice needs to remain non-judgemental and patient focused regardless of whether voluntary assisted dying policy was implemented or not. Both opportunities and risks associated with implementation were identified by the participants.ConclusionThere was common ground around the respect for the dying person and the ideal of a “safe place” despite opposing views on what this may mean in practice. There is a need for clarity in organisational responses around policy, risk management, education, and staff support.

Highlights

The Voluntary Assisted Dying (VAD) Act 2019 [1] was passed in Western Australia (WA) in 2019 with full enactment of the legislation scheduled for mid-2021
While there was an even spread of years of association among community members, eight
Like Blaschke et al, who reported differing perceptions of healthcare professionals as to where VAD sat in meeting their common goal of relief of suffering and facilitating a good death [19], our work highlighted that a cross-community alliance can be formed around areas of shared commitment

Summary

Introduction

The Voluntary Assisted Dying (VAD) Act 2019 [1] was passed in Western Australia (WA) in 2019 with full enactment of the legislation scheduled for mid-2021. Many jurisdictions had a defined period for implementation prior to full enactment of their laws, allowing time for dialogue about how healthcare services will respond, there is minimal literature on the interface between palliative care and legalised VAD to guide services in conversations with both internal and external stakeholders. Published information on VAD implementation focuses on large centres in which palliative care provision is only one aspect. There is a lack of research to guide the implementation of voluntary assisted dying legislation within a hospice setting. The aim of this study was to explore the expectations of staff, volunteers and members of the community as how a rural Australian community hospice could respond in relation to imminent enactment of Voluntary Assisted Dying legislation

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