With parts of the UK debating end-of-life legislation, lessons on how it can work in practice can be learned from Australia.
Ahead of the Assisted Dying Bill’s Second Reading in the House of Lords and with responses sought for the Health Education Improvement Wales All Wales Competency Framework for palliative and end of life care, the country is continuing to inch closer to a legal framework for assisted dying.
The Royal College of Physicians Cymru broadly welcomed the framework, but has called for more training.
“We need far greater investment in end-of-life care, including expert decision makers in specialist palliative care in both community and acute settings,” said RCP vice president for Wales, Hilary Williams.
“Many people at the end of life in both hospital and in the community are not receiving the support they need, including supporting decisions around pain management and emotional support, he continued.
Britain is looking closely to Australia for guidance on how to proceed, where it is already legal in six states. Voluntary assisted dying has been legal for six years, beginning in Victoria. In New South Wales, it has been legal for almost two years, and in the Australian Capital Territory – the seventh jurisdiction – the law will come into force this November.
Control to patients
Training is certainly a part of it. As Michael Dooley, director of the Voluntary Assisted Dying pharmacy service in Victoria, told Healthcare Today in March, while he technical aspects of administering the medication are “relatively straightforward”, Victoria, for example, has implemented a structured training programme that all participating doctors are required to complete. “This involves around six hours of reading, online modules and other educational components,” he said.
In an exclusive pair of interviews out later this week, Wade Stedman, clinical lead for New South Wales’ implementation of voluntary assisted dying, and Bhawani O’Brien, a Western Australian GP with decades of end-of-life experience, explain that voluntary assisted dying is about returning control to the patients.
Voluntary assisted dying has given patients “choice and control at the end of life, when they are already dying,” said O’Brien. Stedman agrees. “It’s a choice between dying and dying. The only difference is whether that final stage comes a little earlier and with less suffering,” he said.
