Junior doctors and conscientious objection to voluntary assisted dying: ethical complexity in practice

Area of Science:

• Medical Ethics
• Clinical Practice
• Healthcare Policy

Background:

• Voluntary assisted dying (VAD) is legal in several jurisdictions, with senior doctors typically managing assessments and administration.
• Junior doctors often have peripheral roles in VAD, but possess a right to conscientious objection.
• The legal framework for VAD in Victoria, Australia, grants all health professionals the right to object to participation.

Purpose of the Study:

• To explore the ethical complexities and unique challenges faced by junior doctors regarding conscientious objection to VAD.
• To identify the specific risks and burdens junior doctors encounter when objecting to VAD.
• To inform the development of supportive policies for junior doctors in VAD contexts.

Main Methods:

• Qualitative analysis of ethical considerations for junior doctors in VAD.
• Examination of hierarchical power dynamics within medical teams concerning VAD.
• Review of existing legislation and institutional practices related to conscientious objection.

Main Results:

• Junior doctors experience significant ethical conflict between moral integrity and career progression when objecting to VAD.
• Dependence on senior colleagues creates unique risks, potentially forcing participation or hindering career advancement.
• The subordinate position of junior doctors exacerbates the burden of conscientious objection.

Conclusions:

• Conscientious objection to VAD presents unique ethical challenges for junior doctors due to hierarchical structures.
• Meaningful protection requires more than legal rights; it necessitates robust institutional support and cultural change.
• Jurisdictions must implement specific policies to support junior doctors exercising conscientious objection to VAD.