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21 Jan 2019

If I give my terminally ill patient medication for pain relief and she dies, will I have assisted her death?”

“If my patient is close to death and his family demands treatment, do I have to give it?”

“My elderly patient needs urgent treatment to save her life but refuses to go to hospital. What do I do?”

“My patient’s family is arguing about whether to consent to treatment. Who can make the decision?”

 

These are just some of the legal issues confronting clinicians who care for patients at the end of life. Often the answers are not clear cut, and knowing what to do, particularly in an urgent situation, can be challenging.

While research shows that doctors have significant knowledge gaps about end of life law, most doctors believe law has a place in clinical practice and decision-making, and want to learn more about the law.

To address this need, a team of researchers from the Queensland University of Technology is launching End of Life Law for Clinicians (ELLC), a national training program for clinicians and medical students about the law at end of life. This freely available program, which is funded by the Commonwealth Department of Health, comprises ten 30-minute online modules. It will be launched and open for registration on Thursday, January 31.

Topics include capacity and consent to medical treatment, withholding and withdrawing treatment, Advance Care Directives, substitute decision-making, providing palliative medication, futile or non-beneficial treatment, emergency treatment, end-of-life decision-making for children, and managing disputes.

The training commences with a module about the role of law in end of life care, a topic more relevant to clinicians now than ever before. The past few years have seen significant legal reforms across Australia which have implications for the medical profession, including the Victorian Government’s reforms to laws on medical treatment decision-making. High profile cases like Charlie Gard in the UK have also renewed debate about futile or non-beneficial treatment, and where we should draw the line when it comes to providing treatment to critically ill patients. Legislators, the medical profession, and the broader community are grappling with some of the most complex ethical, moral and legal issues in modern medicine.

For some, law’s role in medicine may not be immediately apparent. Yet law provides the overarching framework for consent to treatment and decision-making in end of life care, and clinicians are important legal actors in this. Caring for patients at the end of life necessarily involves clinicians applying the law in their practice: for example, when a doctor decides whether to follow a person’s Advance Care Directive; how much morphine to administer to a dying patient; or whether mechanical ventilation can be withheld or withdrawn. To do this effectively (and to understand what is lawful, and what is not) knowing end of life law, and where to go for information and advice to manage legal issues, can help.

ELLC comprehensively addresses these issues. It also explains the differences in the laws in all 8 Australian jurisdictions through End of Life Law in Australia, a complementary resource developed for health professionals and the broader community to find out more on end of life law.

In addition to the online modules, 22 workshops, focusing on clinical case studies will be rolled out in all States and Territories throughout 2019, in partnership with the medical and health sectors. CPD points may be claimed from professional Colleges for both modules and workshops, and certificates of completion are available.

Most importantly, applying the law in clinical practice can support individuals to receive care consistent with their goals and preferences, and to experience a ‘good death’. We hope this training program will provide a useful resource to enhance clinicians’ practice.

For more information or to register see: https://palliativecareeducation.com.au/course/index.php?categoryid=5

Authors: 

  • Prof Ben White: Professor of Law, Australian Centre for Health Law Research, Faculty of Law, Queensland University of Technology
  • Prof Lindy Willmott: Professor of Law, Australian Centre for Health Law Research, Faculty of Law, Queensland University of Technology
  • Prof Patsy Yates: Director, Centre for Palliative Care Research and Education and Head of School of Nursing, Queensland University of Technology
  • Dr Shih-Ning Then: Senior Lecturer, Australian Centre for Health Law Research, Faculty of Law, Queensland University of Technology
  • Penny Neller, Project Coordinator, National Palliative Care Projects
  • Dr Rachel Feeney, Senior Research Assistant, End of Life Law for Clinicians

 

 


Published: 21 Jan 2019