Connect
MJA
MJA

Medical assistance in dying: a disruption of therapeutic relationships

Leeroy William
Med J Aust 2018; 209 (7): . || doi: 10.5694/mja17.01217
Published online: 1 October 2018

Medical assistance in dying may disrupt therapeutic relationships and will challenge beliefs

Medical assistance in dying, whether voluntary euthanasia or physician-assisted suicide, has been a recurring topic for societal debate. Voluntary euthanasia is the deliberate and intentional act to end a competent person’s life, at their request, to relieve their suffering.1 Physician-assisted suicide relates to the medical provision of the means or knowledge for someone to commit suicide via the self-administration of a prescribed medication.1 Amid growing societal support2 and stability of worldwide medical opinion, there has been a 66% increase in the legalisation of physician-assisted suicide since 2015,3 which indirectly legitimises such practices through the broad influence it has on societal support. Canada and the American states of California and Colorado legalised physician-assisted suicide in 2016.3 In Australia, the Victorian Parliament passed a Bill in 2017 to legalise physician-assisted suicide, while the debate currently continues in other Australian states and New Zealand. By contrast, in May 2018 Guernsey failed to become the first place in Britain to permit physician-assisted suicide.4


  • 1 Eastern Health, Melbourne, VIC
  • 2 Monash University, Melbourne, VIC


Correspondence: leeroy.william@monash.edu

Competing interests:

No relevant disclosures.

  • 1. Queensland University of Technology. End of life law in Australia. Euthanasia and assisted dying. https://end-of-life.qut.edu.au/euthanasia#547411 (accessed Aug 2018).
  • 2. Emanuel EJ, Onwuteaka-Philipsen BD, Urwin JW, Cohen J. Attitudes and practices of euthanasia and physician-assisted suicide in the United States, Canada, and Europe. JAMA 2016; 316: 79-90.
  • 3. Kennedy Institute of Ethics, Georgetown University. Euthanasia regulations around the world. https://ethicslab.georgetown.edu/euthanasia-map/ (accessed Aug 2018).
  • 4. Sherwood H. Guernsey parliament votes against assisted dying. The Guardian 2018; 18 May. https://www.theguardian.com/society/2018/may/18/guernsey-parliament-votes-against-assisted-dying (accessed Aug 2018).
  • 5. Hendry M, Pasterfield D, Lewis R, et al. Why do we want the right to die? A systematic review of the international literature on the views of patients, carers and the public on assisted dying. Palliat Med 2012; 27: 13-26.
  • 6. Kelly BJ, Varghese FT, Pelusi D. Countertransference and ethics: a perspective on clinical dilemmas in end-of-life decisions. Palliat Support Care 2003; 1: 367-375.
  • 7. Saini V, Garcia-Armesto S, Klemperer D, et al. Drivers of poor medical care. Lancet 2017; 390: 178-190.
  • 8. Estacio CF, Butow PN, Lovell MR, et al. Exploring symptom meaning: perspectives of palliative care physicians. Support Care Cancer 2018; 26: 2769-2784.
  • 9. Beauchamp TL, Childress JF. Principles of biomedical ethics. 3rd ed. New York, Oxford: Oxford University Press, 1989.
  • 10. Working Party of the Royal College of Physicians. Doctors in society: medical professionalism in a changing world. Clin Med (Lond) 2005; 5 (6 Suppl 1): S5-S40.
  • 11. Bergman YS, Bodner E, Haber Y. The connection between subjective nearness-to-death and depressive symptoms: the mediating role of meaning in life. Psychiatry Res 2018; 261: 269-273.
  • 12. McKenzie EL, Brown PM, Mak AS, Chamberlain P. “Old and ill”: death anxiety and coping strategies influencing health professionals’ well-being and dementia care. Aging Ment Health 2017; 21: 634-641.
  • 13. Belmi P, Pfeffer J. Power and death: mortality salience increases power seeking while feeling powerful reduces death anxiety. J Appl Psychol 2016; 101: 702-720.
  • 14. Virdun C, Luckett T, Lorenz K, et al. Dying in the hospital setting: a meta-synthesis identifying the elements of end-of-life care that patients and their families describe as being important. Palliat Med 2017; 31: 587-601.
  • 15. Smith C, Bosanquet N, Riley J, Koffman J. Loss, transition and trust: perspectives of terminally ill patients and their oncologists when transferring care from the hospital into the community at the end of life. BMJ Support Palliat Care 2016; doi: 10.1136/bmjspcare-2015-001075.
  • 16. Wong PTP, Reker GT, Gesser G. Death attitude profile-revised: a multidimensional measure of attitudes toward death. In: Neimeyer RA. Death anxiety handbook: research, instrumentation, and application. Washington DC: Taylor & Francis, 1994.
  • 17. Thiemann P, Quince T, Benson J, et al. Medical students’ death anxiety: severity and association with psychological health and attitudes toward palliative care. J Pain Symptom Manage 2015; 50: 335-342.

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.