Effective approaches to regulating voluntary assisted dying: a qualitative study of doctors and regulators
Ben White1, Casey Haining1, Lindy Willmott1, Australian Centre for Health Law Research, Queensland University of Technology Brisbane 1Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, QLD, Australia
Abstract
Introduction: The safe operation of voluntary assisted dying systems depends on effective regulation. Australian voluntary assisted dying systems draw on a range of regulatory tools to ensure compliance including law, policy, training and system design. A key part of this regulation is directed at doctors. Yet little is known about the most effective ways for regulation to influence doctors’ medical practice.
Methods: Semi-structured interviews were conducted with doctors who provide voluntary assisted dying and regulators (those whose role involves “altering behaviour” in this field, including non-State actors such as professional and advocacy groups). Interviews were conducted in both Victoria and Western Australia. Participants were asked about the best way to regulate voluntary assisted dying, including how to most effectively guide participating doctors to follow the processes set out in the law. Thematic analysis was undertaken.
Results: The interview sample included 39 doctors and 54 regulators. Participants identified a range of ways in which voluntary assisted dying can be effectively regulated and reflected on strengths and weaknesses of different forms of current regulation. Preliminary findings include that peer opinion and professional consensus were powerful forms of regulation, and that law has a role to play but has limitations in guiding clinical practice.
Conclusion: Regulation design should be guided by the perspectives of the intended target of that regulation. Existing voluntary assisted dying regulation can be enhanced through utilising those forms of guidance which are most influential for doctors.
Biography
Ben White is a Professor of End-of-Life Law and Regulation at the Australian Centre for Health Law Research at QUT. He has been researching end-of-life law, policy and practice for over 20 years, and now focuses on voluntary assisted dying. Ben’s work has contributed to evidence-based voluntary assisted dying law reform and implementation. Key work (with Lindy Willmott) includes their model Voluntary Assisted Dying Bill and developing the mandatory training in Victoria, Western Australia and Queensland for clinicians providing voluntary assisted dying. He is currently undertaking a 4-year Future Fellowship project funded by the Australian Research Council examining optimal regulation of voluntary assisted dying.