Telehealth use in Voluntary Assisted Dying: a systematic review

This study aimed to identify how telehealth supports access to Voluntary Assisted Dying (VAD) globally and explore potential risks and benefits of telehealth for VAD consultations.

A systematic review of peer-reviewed articles on telehealth and VAD examining global use of telehealth to support access to VAD, global restrictions to telehealth-enabled VAD, and practical and clinical implications of using telehealth in supporting VAD was performed. PubMed, Embase (Excerpta Medica Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science, and Scopus were searched and supplemented by handsearching relevant articles. Study quality was assessed using the SQUIRE (The Standard for Quality Improvement Reporting Excellence) guidelines.

Two hundred and thirty articles were identified and then screened by two reviewers. Data were extracted from 26 included articles. Guided by Braun and Clarke's thematic analysis methodology, manual open coding was undertaken, and peer debriefing meetings resulted in the final key themes. Overall, findings indicate that telehealth can facilitate VAD services, enhance patient and provider experiences, and mitigate access inequities. The analysis highlighted that telehealth could further improve VAD access, especially in rural and remote areas. Until then, there are ongoing legal ambiguities for providers in Australia.

Telehealth can improve access to VAD, particularly in remote areas, reducing travel burdens for terminally ill patients. Global evidence from VAD and other sensitive medical fields supports the conclusion that telehealth's benefits outweigh its risks. Legislative clarity in Australia is necessary to resolve conflicts between federal and state laws and to provide clarity for healthcare providers and improve access for eligible patients. Future research should include more robust measures of the efficacy of telehealth.