Enough already about conscientious objection in voluntary assisted dying – what about the conscientious participants?

Dr Jodhi Rutherford1

1QUT, Australia

It is known that in many places where VAD is legal, most doctors choose to not provide it. This can create access barriers for otherwise eligible persons seeking VAD if they are unable to locate a willing provider. Clinicians’ right to conscientious objection is protected in most jurisdictions which permit VAD, but not all clinicians who decline to participate do so because of a conscientious objection. Many elect to not participate because of anticipated personal (e.g. emotional toll, stress, or fear) or professional (e.g. reputational stigma, conflict with colleagues) reasons. These reasons are well documented in the literature, as are clinicians’ conscientious objections.

Less well documented are the reasons that clinicians provide towards their participation in VAD. Where the potential for access barriers to VAD are high because of a short supply of willing clinicians, one important mitigation is to understand and support those factors which doctors (and nurses) say motivate them to be involved in this type of medical practice. To better identify and understand these factors, 25 doctors with no in-principle opposition to doctors legally providing VAD were interviewed in the first year of the operation of the VAD law in Victoria. This small empirical study observed that doctors commonly utilise bioethical justifications for their involvement in VAD but struggle to reconcile that approach with the broader medical profession’s opposition. Participants identify autonomy (of both patient and physician), beneficence (relief of suffering; a better way to die; the reassuring effect of legal access) and justice (effective regulation; facilitating a patient’s legal right) as ethical imperatives for conscientious participation.


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