Ms Madeleine Archer1
1Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Australia
Biography:
Madeleine Archer is a Postdoctoral Research Fellow at the Australian Centre for Health Law Research, Queensland University of Technology. Her research uses regulatory theory and qualitative methods to examine how regulation impacts voluntary assisted dying practice in Belgium. She is also a legal writer for the Queensland and Western Australian voluntary assisted dying mandatory training for health professionals.
Abstract:
Background:
Assisted dying is being increasingly legalised internationally. In those jurisdictions, this practice is being tightly regulated. It is not just legislation which seeks to shape how assisted dying is practised: professional guidelines, court decisions, system infrastructure, and training programs also seek to do this. Recent research shows that Belgium is one such jurisdiction which tightly regulates assisted dying or ‘euthanasia.’
Aims:
We sought to identify the influence that regulation has on the practice of health professionals who provide euthanasia in Belgium.
Methods:
We conducted 20 semi-structured interviews with eligible health professionals. Interviews were conducted over Microsoft Teams videoconferencing from September 2022 to March 2024. Transcripts were analysed using a reflexive approach to thematic analysis.
Results:
We generated three themes describing the influence of regulation on Belgian euthanasia practice, encompassing several sub-themes and sub-sub themes. These are that (1) the euthanasia legislation is an important, boundary-setting instrument for authorising euthanasia, (2) the legislation is limited, making space for gap filling and other forms of regulation, and (3) relying on individual judgement can make practitioners feel vulnerable to sanction.
Conclusions:
Though the Belgian euthanasia legislation is an important source of guidance on euthanasia provision, providers rely on their own independent judgement and clinical discretion to a large extent. This has implications for the control, consistency, and quality of euthanasia provision in Belgium. Policymakers in Belgium and internationally should reflect on this Belgian approach and its implications for patients’, providers’, and regulators’ experiences of assisted dying.