Week 5 Flashcards
The Panel was asked to develop a safe & compassionate framework & did so taking into account agreed principles:
– every human life has equal value.
– a person’s autonomy should be respected.
– informed decision making.
– quality care that minimises suffering & maximises quality of life.
– therapeutic relationships be supported & maintained.
– open discussions about death & dying.
– conversations about treatment & care preferences.
– genuine choice balanced with safeguards.
– all people have the right to be shown respect for their culture, beliefs, values & personal characteristics.
who will be eligible for VAD?
To access voluntary assisted dying, an individual must be an adult 18 years or older, reside in Victoria for at least 12 months, have decision-making capacity regarding assisted dying, and be diagnosed with an incurable disease that is advanced, progressive, and causes unrelievable suffering. Prognosis has to be 6 months or within 12 months for neurodigenarative
the request & assessment process
A person must make three separate requests: first request to a medical practitioner, undergo a first assessment by the coordinating practitioner, undergo a second independent assessment by the consulting practitioner, inform other care providers, explain the process to family members, make a witnessed declaration, and finalize the request.
the role of medical practitioners
Two assessing medical practitioners, a coordinating and consulting one, are responsible for ensuring a person is informed about treatment options and outcomes. They must conduct independent assessments to determine eligibility, understanding, voluntary action, and enduring requests, while respecting conscientious objections as legal.
medication monitoring
The policy requires a contact person to return unused medication within 15 days of death, obtaining a permit from DHHS, and ensuring medication labels are clear, safe, and stored in a locked box. It also requires reporting to the Review Board within 7 days of prescription authorization, dispensement, and return of lethal medication.
oversight for voluntary assisted dying
The Review Board monitors activity through a database, requires mandatory reporting on assessment completion within 7 days, authorization certification within 7 days, and medication administration within 7 days. It also requires unused medication to be returned and dispensed by the pharmacist.
implementation
The implementation taskforce will lead until June 19, 2019, integrating care models into existing processes, ensuring continuity across treatment options, testing approaches, developing resources, and considering practical considerations. Supported by the Department of Health & Human Services, focus on research and quality approaches.
Voluntary Assisted Dying (VAD)
a major legal, ethical and social policy issue. In Australia, VAD is lawful in all States - Victoria, Western Australia, Tasmania, South Australia, Queensland, and New South Wales. VAD laws have been passed in the Australian Capital Territory and will commence on 3 November 2025.
Impact of patient deaths
When we care for patients at end-of-life, it is important for us to consider the impact of patient’s death on familly, friends, informal carers and formal carers including us (healthcare professionals).
One difficulty we may face is to witness family members’ grief, but also we (as a healthcare professinal) may grieve after establishing a therapeutic relationship with the patient. Therefore, we must have some understanding about loss and grief, and need to plan how to care for ourselves if we are also grieving.
Worden’s Tasks of Mourning
Worden (1977 and subsequently) described 4 tasks of mourning that a person needs to complete in order to make an adjustment to their loss:
- To accept the reality of the loss
- To work through the pain and grief of the loss
- To adjust to an environment in which the deceased is missing
- To relocate the deceased and move on
Kubler-Ross’s Model of Grieving
5 stage model of grieving, inclusive of denial, anger, bargaining, depression and acceptance. It was extremely controversial at a time when medicine was ‘paternalistic’ and did not want to tell patients how ill they really were. She was largely responsible for making death a legitimate topic for both medicine and research.
Stroebe and Shut’s Dual Process Model of Coping
dual process model of coping accepts that grief can be both helpful and detrimental depending on the circumstances. Expressing and controlling feelings are important and oscillation between coping behaviours is perfectly acceptable as grief is viewed as a dynamic process in which the focus can shift from a loss orientation or a restoration orientation.
