Aboriginal and/or Torres Strait Islander Peoples and end of life decision-making
Penny Neller1, Australian Centre for Health Law Research, QUT Brisbane 1Australian Centre for Health Law Research, QUT, Brisbane, QLD, Australia
Abstract
Authors: Ms Penny Neller, Prof Lindy Willmott, Prof Ben White, Prof Shih-Ning Then, and Dr Rachel Feeney, Australian Centre for Health Law Research, Faculty of Business and Law, QUT, and Distinguished Professor Patsy Yates, Faculty of Health, QUT.
Aboriginal and/or Torres Strait Islander Peoples’ unique and diverse cultures; connection to Country, family and community; and cultural beliefs and knowledge are intrinsically linked to maintaining health and wellbeing. These factors can profoundly influence approaches to death, dying and end-of-life decision-making. Also relevant are historical, social, economic, and health experiences, including the legacy of colonisation, past and continuing discrimination and trauma, and challenges accessing end-of-life care.
There is a dearth of training for health professionals on end-of-life decision-making with Aboriginal and/or Torres Strait Islander individuals, families and communities. As part of the End of Life Law for Clinicians (ELLC) national training program, we analysed Australian law and literature, and consulted with Indigenous health professionals and stakeholders to identify the key legal considerations that may arise when caring for Aboriginal and Torres Strait Islander Peoples at the end-of-life. This process informed the co-design of a new online training module, Aboriginal and/or Torres Strait Islander Peoples and end-of-life law, launched in September 2022.
The analysis and consultation revealed two key themes:
1. The importance of clear, honest, respectful and culturally appropriate communication with Aboriginal and/or Torres Strait Islander Peoples. This is critical to determining capacity, obtaining consent, decision-making, and effective communication between individuals, families, and health professionals.
2. The role of collective decision-making. Depending on the person, decision-making may occur individually, or collectively with family and community.
These findings, and the training it informed, can support delivery of Culturally Safe and Culturally Responsive end-of-life and palliative care for Aboriginal and Torres Strait Islander Peoples.
Biography
Penny Neller is the National Palliative Care Projects Manager at the Australian Centre for Health Law Research, Faculty of Business and Law, Queensland University of Technology. She manages two projects funded by the Australian Government Department of Health and Aged Care: the End of Life Law for Clinicians training program, and the End of Life Directions for Aged Care End of Life Law Toolkit. Penny co-authors the website End of Life Law in Australia. She is a lawyer with experience in end of life law, health and social policy, and systemic advocacy for vulnerable groups.