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Physician assisted dying – the for and against amongst nursing and medical associations

Medicine, Nursing, The Health Industry

The Victorian Voluntary Assisted Dying Bill passing the Legislative Council has spurred vastly differing views from organisations including the Australian Nursing and Midwifery Federation (ANMF), the Australian College of Nursing (ACN), the Australian Medical Association (AMA), and Palliative Care Australia (PCA).

The ANMF and ACN expressed approval of the physician assisted suicide with ANMF further expressing its delight that politicians have listened to their long-standing appeal.

ANMF Federal Secretary Lee Thomas said, “The ANMF, in collaboration with the ANMF Victorian Branch, have long campaigned for laws which ensure that people suffering from terminal and incurable illnesses, are provided with the power and protection to have choices about the timing and manner of their death.”

Prior to the passing of the law in November, nurses from the ACN, had also identified the indispensable need for nationwide discussions about supporting individual patient choice for voluntary assisted dying.

Australian College of Nursing CEO, Adjunct Professor Kylie Ward, said, “Over the past 12 months we have asked the profession to tell us their policy priorities. More patient choice regarding end-of-life care was one of four topics nurses asked us to discuss at our first annual National Policy Forum, which we held in April.”

While these two nursing organisations are adamant that patients need to have dignity and choice at end-of-life, the AMA’s position is the exact opposite, claiming that they are largely in line with the World Medical Association (WMA) policy in stating that ’doctors should not be involved in interventions that have as their primary intention the ending of a person’s life’.

“The AMA has grave concerns about the Voluntary Assisted Dying Bill currently before the Victorian Parliament, and we oppose it.” said AMA President, Dr Michael Gannon.

All the same, Dr Gannon clarified that the laws in relation to Euthanasia and Physician Assisted Suicide are ultimately a matter for society and government, and that AMA have not and will not describe doctors who support or participate in Euthanasia as unethical. He also recognizes that doctors who participate in Physician Assisted Suicide are more likely to require the industrial, professional, medico-legal, and pastoral support of organisations like the AMA.

Palliative Care Australia has raised these points with respect to physician assisted dying:

  • The need for increased funding for palliative care services to ensure all Australians can access support at the end of life and to raise community awareness and normalise discussion about death and dying
  • The need to address the gap in palliative care services particularly in rural and regional areas caused by factors such as location, diagnosis, ethnicity or socio-economic status
  • The need for access to grief and bereavement support
  • The need to upskill health professionals outside of the palliative care sector such as GPs, nurses, aged care staff, allied health and other health professionals to ensure they are equipped with the knowledge and skills to best support people with a life-limiting illness and their carers

Despite not having a final position on the issue of voluntary assisted dying, PCA strongly stated that palliative care practice does not include euthanasia and physician assisted dying.

“PCA’s position is that euthanasia and physician assisted suicide are not part of palliative care practice. However, it is a complex issue and like the broader community, there are varying opinions within the palliative care sector. Ultimately it will be up to services and health professionals to decide to what extent they will be involved in a request for voluntary assisted dying from a person in their care.” PCA President Dr Jane Fischer said.

Image: Alberto Biscalchin – Flickr 

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