15 found
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  1.  25
    Better Regulation of End-Of-Life Care: A Call For A Holistic Approach.Ben P. White, Lindy Willmott & Eliana Close - 2022 - Journal of Bioethical Inquiry 19 (4):683-693.
    Existing regulation of end-of-life care is flawed. Problems include poorly-designed laws, policies, ethical codes, training, and funding programs, which often are neither effective nor helpful in guiding decision-making. This leads to adverse outcomes for patients, families, health professionals, and the health system as a whole. A key factor contributing to the harms of current regulation is a siloed approach to regulating end-of-life care. Existing approaches to regulation, and research into how that regulation could be improved, have tended to focus on (...)
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  2.  27
    Junior doctors and conscientious objection to voluntary assisted dying: ethical complexity in practice.Rosalind J. McDougall, Ben P. White, Danielle Ko, Louise Keogh & Lindy Willmott - 2022 - Journal of Medical Ethics 48 (8):517-521.
    In jurisdictions where voluntary assisted dying is legal, eligibility assessments, prescription and administration of a VAD substance are commonly performed by senior doctors. Junior doctors’ involvement is limited to a range of more peripheral aspects of patient care relating to VAD. In the Australian state of Victoria, where VAD has been legal since June 2019, all health professionals have a right under the legislation to conscientiously object to involvement in the VAD process, including provision of information about VAD. While this (...)
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  3.  26
    The impact on patients of objections by institutions to assisted dying: a qualitative study of family caregivers’ perceptions.Ben P. White, Ruthie Jeanneret, Eliana Close & Lindy Willmott - 2023 - BMC Medical Ethics 24 (1):1-12.
    Background Voluntary assisted dying became lawful in Victoria, the first Australian state to permit this practice, in 2019 via the Voluntary Assisted Dying Act 2017 (Vic). While conscientious objection by individual health professionals is protected by the Victorian legislation, objections by institutions are governed by policy. No research has been conducted in Victoria, and very little research conducted internationally, on how institutional objection is experienced by patients seeking assisted dying. Methods 28 semi-structured interviews were conducted with 32 family caregivers and (...)
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  4.  40
    Doctors’ perceptions of how resource limitations relate to futility in end-of-life decision making: a qualitative analysis.Eliana Close, Ben P. White, Lindy Willmott, Cindy Gallois, Malcolm Parker, Nicholas Graves & Sarah Winch - 2019 - Journal of Medical Ethics 45 (6):373-379.
    ObjectiveTo increase knowledge of how doctors perceive futile treatments and scarcity of resources at the end of life. In particular, their perceptions about whether and how resource limitations influence end-of-life decision making. This study builds on previous work that found some doctors include resource limitations in their understanding of the concept of futility.SettingThree tertiary hospitals in metropolitan Brisbane, Australia.DesignQualitative study using in-depth, semistructured, face-to-face interviews. Ninety-six doctors were interviewed in 11 medical specialties. Transcripts of the interviews were analysed using thematic (...)
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  5.  44
    Law as Clinical Evidence: A New ConstitutiveModel of Medical Education and Decision-Making.Malcolm Parker, Lindy Willmott, Ben White, Gail Williams & Colleen Cartwright - 2018 - Journal of Bioethical Inquiry 15 (1):101-109.
    Over several decades, ethics and law have been applied to medical education and practice in a way that reflects the continuation during the twentieth century of the strong distinction between facts and values. We explain the development of applied ethics and applied medical law and report selected results that reflect this applied model from an empirical project examining doctors’ decisions on withdrawing/withholding treatment from patients who lack decision-making capacity. The model is critiqued, and an alternative “constitutive” model is supported on (...)
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  6.  31
    Reasons doctors provide futile treatment at the end of life: a qualitative study.Lindy Willmott, Benjamin White, Cindy Gallois, Malcolm Parker, Nicholas Graves, Sarah Winch, Leonie Kaye Callaway, Nicole Shepherd & Eliana Close - 2016 - Journal of Medical Ethics 42 (8):496-503.
    Objective Futile treatment, which by definition cannot benefit a patient, is undesirable. This research investigated why doctors believe that treatment that they consider to be futile is sometimes provided at the end of a patient9s life. Design Semistructured in-depth interviews. Setting Three large tertiary public hospitals in Brisbane, Australia. Participants 96 doctors from emergency, intensive care, palliative care, oncology, renal medicine, internal medicine, respiratory medicine, surgery, cardiology, geriatric medicine and medical administration departments. Participants were recruited using purposive maximum variation sampling. (...)
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  7.  16
    Institutional Objection to Voluntary Assisted Dying in Victoria, Australia: An Analysis of Publicly Available Policies.Eliana Close, Lindy Willmott, Louise Keogh & Ben P. White - 2023 - Journal of Bioethical Inquiry 20 (3):467-484.
    Background Victoria was the first Australian state to legalize voluntary assisted dying (elsewhere known as physician-assisted suicide and euthanasia). Some institutions indicated they would not participate in voluntary assisted dying. The Victorian government issued policy approaches for institutions to consider Objective To describe and analyse publicly available policy documents articulating an institutional objection to voluntary assisted dying in Victoria. Methods Policies were identified using a range of strategies, and those disclosing and discussing the nature of an institutional objection were thematically (...)
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  8.  49
    Charlie Gard: in defence of the law.Eliana Close, Lindy Willmott & Benjamin P. White - 2018 - Journal of Medical Ethics 44 (7):476-480.
    Much of the commentary in the wake of the Charlie Gard litigation was aimed at apparent shortcomings of the law. These include concerns about the perceived inability of the law to consider resourcing issues, the vagueness of the best interests test and the delays and costs of having disputes about potentially life-sustaining medical treatment resolved by the courts. These concerns are perennial ones that arise in response to difficult cases. Despite their persistence, we argue that many of these criticisms are (...)
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  9.  22
    The role of law in decisions to withhold and withdraw life-sustaining treatment from adults who lack capacity: a cross-sectional study.Benjamin P. White, Lindy Willmott, Gail Williams, Colleen Cartwright & Malcolm Parker - 2017 - Journal of Medical Ethics 43 (5):327-333.
    Objectives To determine the role played by law in medical specialists9 decision-making about withholding and withdrawing life-sustaining treatment from adults who lack capacity, and the extent to which legal knowledge affects whether law is followed. Design Cross-sectional postal survey of medical specialists. Setting The two largest Australian states by population. Participants 649 medical specialists from seven specialties most likely to be involved in end-of-life decision-making in the acute setting. Main outcome measures Compliance with law and the impact of legal knowledge (...)
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  10.  18
    Balancing Patient and Societal Interests in Decisions About Potentially Life-Sustaining Treatment: An Australian Policy Analysis.Eliana Close, Ben P. White & Lindy Willmott - 2020 - Journal of Bioethical Inquiry 17 (3):407-421.
    BackgroundThis paper investigates the content of Australian policies that address withholding or withdrawing life-sustaining treatment to analyse the guidance they provide to doctors about the allocation of resources.MethodsAll publicly available non-institutional policies on withholding and withdrawing life-sustaining treatment were identified, including codes of conduct and government and professional organization guidelines. The policies that referred to resource allocation were isolated and analysed using qualitative thematic analysis. Eight Australian policies addressed both withholding and withdrawing life-sustaining treatment and resource allocation.ResultsFour resource-related themes were (...)
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  11.  37
    Persistent vegetative state and minimally conscious state: ethical, legal and practical dilemmas.Lindy Willmott & Ben White - 2017 - Journal of Medical Ethics 43 (7):425-426.
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  12.  22
    A qualitative study of experiences of institutional objection to medical assistance in dying in Canada: ongoing challenges and catalysts for change.Eliana Close, Ruthie Jeanneret, Jocelyn Downie, Lindy Willmott & Ben P. White - 2023 - BMC Medical Ethics 24 (1):1-24.
    Background In June 2016, Canada legalized medical assistance in dying (MAiD). From the outset, some healthcare institutions (including faith-based and non-faith-based hospitals, hospices, and residential aged care facilities) have refused to allow aspects of MAiD onsite, resulting in patient transfers for MAiD assessments and provision. There have been media reports highlighting the negative consequences of these “institutional objections”, however, very little research has examined their nature and impact. Methods This study reports on findings from 48 semi-structured qualitative interviews conducted with (...)
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  13.  31
    Junior Medical Officers’ knowledge of advance care directives and substitute decision making for people without decision making capacity: a cross sectional survey.Rob Sanson-Fisher, Mathew Clapham, Mary-Ann Ryall, Anne Knight, Emma Price, Carolyn Hullick, Robert Pickles, Lindy Willmott, Ben P. White, Alison Bowman, Jamie Bryant & Amy Waller - 2022 - BMC Medical Ethics 23 (1):1-7.
    BackgroundJunior medical doctors have a key role in discussions and decisions about treatment and end-of-life care for people with dementia in hospital. Little is known about junior doctors’ decision-making processes when treating people with dementia who have advance care directives, or the factors that influence their decisions. To describe among junior doctors in relation to two hypothetical vignettes involving patients with dementia: their legal compliance and decision-making process related to treatment decisions; the factors influencing their clinical decision-making; and the factors (...)
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  14.  2
    Voluntary assisted dying in Victoria: Why knowing the law matters to nurses.Jayne Hewitt, Ben White, Katrine Del Villar, Lindy Willmott, Laura Ley Greaves & Rebecca Meehan - 2021 - Nursing Ethics 28 (2):221-229.
    In 2017, Victoria became the first state in Australia to pass legislation permitting voluntary assisted dying. Under this law, only those people who are near the end of their lives may access voluntary assisted dying, and because many of these people require nursing care to manage the progression of their illness or their symptoms, it will invariably have an impact on nursing practice. The Victorian law includes a series of procedural steps as safeguards to ensure that the law operates as (...)
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  15.  16
    International perspectives on end-of-life law reform: politics, persuasion, and persistence.Ben White & Lindy Willmott (eds.) - 2021 - New york, NY: Cambridge University Press.
    However, the barriers and facilitators of such changes - law reform perspectives - have been virtually ignored. Why do so many attempts to change the law fail but others are successful? International Perspectives on End-of-Life Law Reform aims to address this question by drawing on ten case studies of end-of-life law reform from the United Kingdom, the United States, Canada, the Netherlands, Belgium and Australia. Written by leading end-of-life scholars, the book's chapters blend perspectives from law, medicine, bioethics and sociology (...)
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