Abstract
BackgroundIn June 2019, the Australian state of Victoria joined the growing number of jurisdictions around the world to have legalised some form of voluntary assisted dying. A discourse of safety was prominent during the implementation of the Victorian legislation.Main textIn this paper, we analyse the ethical relationship between legislative “safeguards” and equal access. Drawing primarily on Ruger’s model of equal access to health care services, we analyse the Victorian approach to voluntary assisted dying in terms of four dimensions: horizontal equity, patient agency, high quality care, and supportive social norms. We argue that some provisions framed as safeguards in the legislation create significant barriers to equal access for eligible patients.ConclusionsWhile safety is undoubtedly ethically important, we caution against an overemphasis on safeguarding in voluntary assisted dying legislation given the implications for equal access.
Highlights
Conceptualising equal access to health services In the bioethics literature globally, equal access to voluntary assisted dying (VAD) for eligible patients has not been the subject of detailed ethical analysis
Some form of voluntary assisted dying is permitted in the Netherlands, Canada, Belgium, Colombia, Switzerland and Luxembourg as well as in ten states of the US, and Victoria recently joined this group of jurisdictions [2, 3]
We argue that various safeguards in the Victorian approach create significant barriers to equal access
Summary
While safety is undoubtedly ethically important, we caution against an overemphasis on safeguarding in voluntary assisted dying legislation given the implications for equal access.
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