Does voluntary assisted dying impact quality palliative care? A retrospective mixed-method study

Area of Science:

• Palliative Care
• End-of-Life Care
• Medical Ethics

Background:

• Voluntary assisted dying (VAD) legislation is expanding across Australian states.
• The integration of VAD services presents new challenges for palliative care delivery.
• Understanding the interplay between VAD pursuit and palliative care quality is crucial.

Purpose of the Study:

• To investigate the relationship between seeking voluntary assisted dying (VAD) and the quality of palliative care received.
• To analyze how VAD inquiries impact various domains of patient care.
• To identify factors influencing the patient's choice between VAD and palliative care.

Main Methods:

• Retrospective convergent mixed-methods design.
• Analysis of records from 141 patients over two years who expressed interest in VAD.
• Correlation of patient data with quality of care domains.

Main Results:

• Patients seeking VAD often cited autonomy, suffering, and fear of future suffering as primary reasons.
• VAD inquiries influenced whole person care, family caregiving, and palliative care teams.
• Open communication positively impacted therapeutic adherence and timely palliative care access.
• Withholding information negatively affected patient relationships.

Conclusions:

• Palliative care must adapt to support patients pursuing VAD.
• Further research is needed to ensure enhanced palliative care quality for VAD patients.
• Support for caregivers and healthcare staff accompanying patients through VAD is essential.