Do concerns about legal and ethical risk affect the provision of pain relief at the end of life?

Project Overview: The aim of this study is to determine the extent to which health professionals’ beliefs about the law prevent them from providing effective pain and symptom control to patients at the end of life. The first phase of the research was to review publicly reported cases in which the conduct of health professionals in prescribing or administering medication was reviewed in legal or disciplinary fora. The second phase was empirical research involving interviews with 25 nurses who regularly work with patients at the end of life to explore the extent to which potential legal or professional consequences affect their practice in the provision of pain and symptom relief. Analysis is underway. The study findings will inform strategies to improve health professionals’ understanding of legal protections of appropriate medical practice at the end of life.

Project status: In progress.

An Australian pilot study: Incidence and characteristics of end-of-life decisions.

Project Overview: Increasingly, due to advances in medical technologies, deaths in Australia occur after a medical decision to provide or limit treatment. The goal of this project is to describe the frequency and nature of these medical end-of-life decisions (MELDs), which take several forms, including withholding and withdrawing life-prolonging measures and alleviating pain with potentially life-shortening doses of opioids, and more rarely, the deliberate ending of life and assisting a person to do so. This study will obtain data about these decisions from a national cross-sectional survey of doctors who treat patients at the end of life, using a validated survey instrument. The study findings are vital to inform the laws and policies that regulate end-of-life decision-making in Australia and will serve as an important foundation to monitor future regulatory change.

Project status: In progress.