Clinician perspectives on voluntary assisted dying and willingness to be involved: a multisite, cross-sectional survey during implementation in New South Wales, Australia

Edwina Light; Ian Kerridge; George Skowronski; Venkatesha Venkatesha; Aravind Krishnamurthy; Suzanne Kuper; Kerrie Noonan; Philip Hoyle; Mark Arnold; Stephen Manley; Wade Stedman; Linda Sheahan

doi:10.1111/imj.16305

Clinician perspectives on voluntary assisted dying and willingness to be involved: a multisite, cross-sectional survey during implementation in New South Wales, Australia

Intern Med J. 2024 May;54(5):724-734. doi: 10.1111/imj.16305. Epub 2023 Dec 14.

Authors

Edwina Light^{1

2}, Ian Kerridge^{1

3

4}, George Skowronski^{1

5

6}, Venkatesha Venkatesha⁷, Aravind Krishnamurthy⁸, Suzanne Kuper⁹, Kerrie Noonan^{10

11

12}, Philip Hoyle¹³, Mark Arnold^{10

14}, Stephen Manley¹⁵, Wade Stedman^{16

17}, Linda Sheahan^{1

2}

Affiliations

¹ Sydney Health Ethics, School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
² South Eastern Sydney Local Health District, Sydney, New South Wales, Australia.
³ Haematologist and BMT Physician, Royal North Shore Hospital, Sydney, New South Wales, Australia.
⁴ Department of Philosophy, Macquarie University, Sydney, New South Wales, Australia.
⁵ St George Hospital, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia.
⁶ Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
⁷ Northern Sydney Local Health District Executive, Sydney, New South Wales, Australia.
⁸ Clinical Governance Unit, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia.
⁹ Northern NSW Local Health District, Ballina, New South Wales, Australia.
¹⁰ Western NSW Local Health District, Dubbo, New South Wales, Australia.
¹¹ Public Health Palliative Care Unit, La Trobe University, Melbourne, Victoria, Australia.
¹² School of Social Psychology, Western Sydney University, Sydney, New South Wales, Australia.
¹³ Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia.
¹⁴ School of Rural Health, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
¹⁵ Cancer Services and Innovation, Northern NSW Local Health District, Ballina, New South Wales, Australia.
¹⁶ Northern Sydney Local Health District, Sydney, New South Wales, Australia.
¹⁷ VAD Implementation, NSW Health, Sydney, New South Wales, Australia.

PMID: 38093686
DOI: 10.1111/imj.16305

Abstract

Background: In the context of nationwide law reform, New South Wales (NSW) became the last state in Australia to legalise voluntary assisted dying (VAD) - commencing 28 November 2023. Clinicians have divergent views regarding VAD, with varying levels of understanding, support, and willingness to be involved, and these may have a significant impact on the successful implementation.

Aims: To understand levels of support, understanding and willingness to be involved in VAD among clinical staff across NSW during implementation of VAD.

Methods: A multisite, cross-sectional online survey of clinicians across four local health districts, assessing relevant demographics, awareness of and support for VAD legislation and willingness to be involved in different levels of VAD-related clinical activities.

Results: A total of 3010 clinical staff completed the survey. A majority of participants were aware of VAD legislation in NSW (86.35%) and supportive of it (76%), with nursing and allied health clinicians significantly more likely than medical specialists to express support. Among medical specialists, support was statistically more likely in those who did not care for patients at the end of life and those with limited knowledge of the legislation. Willingness of medical specialists to perform key roles was significantly lower, with 41.49% willing to act in coordinating or consulting roles, and only 23.21% as administering practitioners.

Conclusions: The majority of clinical staff surveyed across NSW supported VAD legislation. While many eligible clinicians were reluctant to be actively involved, sufficient numbers appear willing to provide VAD services, indicating that successful implementation should be possible.

Keywords: assisted dying; assisted suicide; clinician attitudes; euthanasia; surveys and questionnaires.

Publication types

Multicenter Study

MeSH terms

Adult
Attitude of Health Personnel*
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
New South Wales
Suicide, Assisted* / legislation & jurisprudence
Suicide, Assisted* / psychology
Surveys and Questionnaires