Australian Health Care System

Introduction to Voluntary Assisted Dying Policy

Euthanasia is one of the unsolved medical issues that have been a major source of debate due to the cons associated with the practice (Sinha et al., 2012). Euthanasia is the process that is defined as the medical procedure in which the third party administers the lethal agent that aims to decrease the relieving the pain and suffering of the patient. The Euthanasia is derived from the Greek library that defines it has “good death” as it aims to decrease the patient intolerable and incurable suffering (Sinha et al., 2012). When the health care professionals deliberately administer the agent to end the patient life suffering extreme health issue called as active euthanasia. Passive euthanasia is considered to switch off the necessary treatment that is important to sustain life (Sinha et al., 2012). The findings are supported by Kalal (2019) by adding that human has to the basic right to life that help them to be safe and no one can harm the. The issue arises when the people asked for the right to die due to suffrage and illness which lead to the controversy of Euthanasia. The voluntary and non-voluntary nature of Euthanasia brings other subtypes of the process and voluntary euthanasia is the process which is performed after the demand of the patient. The non-involuntary euthanasia is the processes that occur without the personal request of the patient due to unresponsiveness nature of the patient.

The euthanasia request has been increased from 37% to 55% from 2005 to 2015 and it majorly depends upon the cause or intensity of the suffering. The major chunk of the population demanding for the euthanasia belong to the old age due to the accumulation of the issue that leads to deteriorated health status. Degenerative disorders are considered to be the major reason behind the health problem accumulation that increases the suffering of the patient (Evenblij et al., 2019). The euthanasia has been the topic of debate due to its major pros and cons that cannot be balanced to identify the major application of the process. Physicians are still not clear about the request of euthanasia and they are needed for the proper guideline to deal such request. There are many places where euthanasia has been legalized and their people have the right to die due to major suffering that will affect them lifelong like Netherland, Belgium and Lichtenstein. This has been a major ethical debate and individual against the euthanasia has proposed many alternatives that can be used to decrease suffering and improve the lives of the patients (Boudreauv & Somerville, 2014). 

Euthanasia has been a major topic for the debate in many countries that uplift the social, legal and political aspect that are in favour or against the process. There are the different factor that has been directly associated with the euthanasia like demographic factor, health care professional factors and policies. The euthanasia has been majorly associated with the negative consequences thus it is illegal in most of the countries but many aspects have been neglected (Young et al., 2019).

SWOT Analysis

Strength

  • End to suffering
  • Death with dignity
  • Free up funds and equipment
  • Patient autonomy

Weakness

  • Devalues human life
  • State Legislature opposition
  • Personal benefit can lead to death

Threat

  • Professional opposition
  • Religious and ethical problem
  • Organization against Euthanasia

Opportunity

  • Improving polices
  • Increasing population awareness

Strength: The strength of the euthanasia is it helps to decrease the suffering of the patient to relieve the pain

  • End to suffering: The article presented by Richards,(2017) discussed that the suffering and pain of the individual will be vanished by the euthanasia. The euthanasia will help the patient to get relief from the lifelong illness that has been increasing issue for the patient.
  • Death with dignity: One of the studies presented by Annadurai et al. (2014) discussed that euthanasia helps the patient suffering from a deadly disease to die with dignity that is right of the individual.
  • Free up funds and equipment’s: According to Goligher et al. (2017) euthanasia helps to reduce the funds and resources that have been utilized to keep the human alive suffering from the deadly disorder which has increased complication.
  • Patient autonomy: The study presented by Kouwenhoven et al. (2019) discussed that patient autonomy is important in the care and euthanasia help to improve the autonomy as it helps the people to have the right to die concerning their suffering and pain.

Weakness: The ethical and political issue associated with the weakness of the euthanasia that directly associated with the breach of the human right.

  • Devalues life: The article presented by Tuffrey-Wijne et al. (2018) discussed that allowing the patient-facing major suffering right to die to lead to devaluing the life that is ethically not right that directly lead to a debate in against of the euthanasia.
  • State Legislature: The study presented by Pereira, (2011) discussed that majorly the entire state legislature passed the order to prohibit the euthanasia that directly decreases its use in the population.
  • Personal benefit: The surrounding individual with the patient can brainwash to adopt for euthanasia to finish the suffering for the benefit they will get after the death of the patient.

Opportunity: There are many opportunities in the area of euthanasia that can be addressed to improve the factors that will help to address the lifelong suffering of the patient

  • Policies: The article presented by Kanniyakonil, (2018) discussed that different policies and law can be framed to improve the picture of the euthanasia that is necessary to address both ethical as well as patient perceptive.
  • Population awareness: The population awareness can be improved to increase their understanding and knowledge concerning the pros and cons of the euthanasia.

Threat: There are different threats for the euthanasia that can directly increase the chances of non-implication of the euthanasia.

  • Professional opposition: Some of the health care professionals are also against the euthanasia due to their standards of practice and professional role and they considered euthanasia unethical (Braverman et al., 2017).
  • Ethical and Religious aspect: Different religions have different thoughts concerning the euthanasia that is one of the major threats.
  • Organization against euthanasia: Different organizations are against the euthanasia and they are doing every possible thing to stop the law in the favour of euthanasia.

The Social and Political Content of Euthanasia

The social context is related to the viewpoint of the different religion concerning the acceptance of the euthanasia as per their belief and values. Islam is against the euthanasia and thinks that Allah is the creator and the destroyer so Allah will choose about the life span of the individual (Shuriye, 2012). The Christianity is also against the euthanasia and the belief is that human should not interfere with the natural phenomena of the life cycle by respecting the importance of life. Judaism also opposes the euthanasia and the population belief that individual should respect life by not altering the wish of the god (Barry et al., 2018).

The political contexts have directly implicated the enforcement of the law concerning the implementation of the euthanasia concerning the patient health condition. There are four Western European countries in which euthanasia is allowed that includes Netherlands, Belgium, Luxembourg and Switzerland. The two North American countries have also allowed euthanasia that is Canada and the United States in the state of Oregon, Vermont, Washington and Montana. Some of the countries due to the political issue have banned the euthanasia and it is considered to be illegal (Castro et al., 2016).

PART B: Executive Summary

The increasing cases of the life-threatening disorder directly increase the wish of the individual to wish for euthanasia. The debate that has been associated with the euthanasia is decreasing its implication in the population that raised the need for the policy. The policy that is framed for implementation of the euthanasia will utilize the holistic approach to improve the understanding concerning the euthanasia. The policy will address the individual, workforce and government role to improve the implementation process. The critical review is also conducted to understand the pros and cons of the topic.

 Policy Introduction

The framing of the policy is a difficult task as all the aspect should be included in the framing to improve success. The accurate framing of the policy is important to address the health of the population that is necessary to improve global health. The steps in the policy framework include problem identification, policy analysis, strategy and policy development, policy enactment, policy implementation and evaluation (Centre for Disease Control and Prevention, 2015).

  • Problem identification: There has been an increasing prevalence of the deadly disease that has increased the suffrage of the patient and they are demanding for euthanasia to end the pain so that they can die with dignity. The debate over the euthanasia has increased the issue for the patient as they are not allowed for the Right to die to relief their pain. The proper use of euthanasia can help the patient under the extreme adverse condition to be relieved and free from pain after death (Abohaimed et al., 2019). The euthanasia is considered to be an issue in medicine, ethics and different religion that hamper its implication with the patient in extreme health status. The legalization of the euthanasia is considered to be in due to the incomplete information of the population concerning the issue (Banović & Turanjanin, 2014).
  • Policy analysis: different health policies can be utilized to address the health issue and they address the different set of the population that are addressed. One of the health policies includes medical research policy that is framed to improve the innovation in the medical field to improve the care. Health workforce policy is framed to improve the understanding and knowledge of the workforce concerning the care procedure to improve the quality of care. Healths in foreign policies are set up to improve economic development and global help. The last is the global health policies that are framed to improve the mass population health (Chinitz, 2019).

The medical research policy can be framed to improve the research in the field does the lifelong illness to provide another alternative of euthanasia. The health workforce policy can be framed to improve their perspective toward mercy killing and better role. The health in foreign policy can be utilized to incorporate their support in the legalisation of the euthanasia. The global health policy can be utilized to improve different factors that are restricting the implementation of the euthanasia (Clancy et al., 2012).

  • Strategy and policy development: The policy that will address the issue associated with the legalisation of the euthanasia will follow the global health policy framework. The framework will address the workforce attitude, government participation and individual assessment.

The first aspect that will be addressed in the policy is improving workforce skills and understanding to deal with the patient suffering from a lifelong illness that has increased pain. The workforce will be assisted to know right handling technique and their important role to maintain patient autonomy for euthanasia.

The second aspect will be addressing the government role in cooperative and helping with the health care professionals to perform euthanasia and reinforce the law. The new law concerning the euthanasia is to be patient-specific that will improve the allowances for the euthanasia as per the patient status.

The last aspect includes individual assessment should be done properly to ensure that there is no way for the improvement. The guidelines are to be framed to set the parameters in which a person can adopt for euthanasia. The assessment process will help to understand that there are no further chances of improvement or treatment that can support patient health.

Critical Analysis

One of the studies presented by Richards, (2017) discussed the patient personal experience concerning the legalizations of the euthanasia. The researcher has clearly stated that during the study they have encountered with both the type of the patient some are willing to perform euthanasia and others have no option other than this to end the suffering. The researcher also discussed that patient also mentioned that when the surrounding individual is not able to address the issue then they think that Euthanasia is the only option to end their suffering. The results are supported by Annadurai et al. (2014) by adding that different factors increase the chances of the patient to wish for euthanasia. The researcher also added that physical and psychological factor increase the complication of the patient suffering from a severe illness that needs to be addressed to decrease the suffering of the patient.

According to Goligher et al. (2017), the quantity of life can be sacrificed in the interest of quality of life to reduce the suffering of the patient. The researcher also added that some suffering has no treatments thus need to be addressed by the death to improve the health care condition. The researcher also added that death should be preferred after proper checking the patient health status so identify any gap that can be addressed treatment. The article also added that death is subjective and all the different aspect should be considered before initiating the euthanasia. The findings are supported by Kouwenhoven, (2019) by adding that euthanasia help to improve the patient autonomy that is important for the care. The article also enlightens that patient autonomy helps the health care providers to understand the patient so that there care can be as per their wish. The research also added that autonomy is important for the patient so that he/she can evaluate their health status and can make the decision for their welfare. The article was concluded by adding that patient in severe condition should be supported and the related concept should be utilized to decrease the vulnerability of the patient.

The opposition of the argument was done by Tuffrey-Wijne et al. (2018) by adding that euthanasia is directly associated with devaluing unethical life. The researcher also added that life is considered to be valuable and performing the euthanasia is not acceptable as it devalues life. The article also added that euthanasia broke the life cycle that is not right concerning the religious and ethical aspect. The results are also supported by Pereira (2011) by adding that the state legislature also prohibited the implementation of the euthanasia as it is not favoured by the majority of the population. The researcher also states that prohibition of the euthanasia at the state level directly decrease the implementation of the euthanasia that is necessary to decrease the suffrage. The article was concluding by adding that lack of support from the state legislature and policy against the euthanasia has increased the barriers for the implementation of the process.

The article presented by Braverman et al. (2017) discussed that reluctance behaviour of the health care professionals can also negatively impact the implementation of the euthanasia. The health care professionals are the major source of the care thus there understanding and supportive nature is important to assist the patient support the patient opting for euthanasia.

Your Position

There are many countries like Netherland which have legalised euthanasia by considering the pain and suffrage of the patient encountered with lifetime illness (Inbadas et al., 2017). Different policies have been framed for the implementation of the euthanasia to address patient suffering. The policy that has been framed considered all the different aspect that will address the individual aspect, organizational aspect and governmental aspect. This policy is considered to be preferable due to its holistic approach which is important to balance the individual as well legal aspect. The current health policy those are present to address the euthanasia is only a single aspect centric that does not cover all aspect which does not implement it properly (Catford, 2018). The three-section of the policy are framed to provide a guideline for all the different aspects that are important to improve the implementation of the euthanasia. Workforces are considered to be an integral part of the care thus they understanding is important which will be addressed by the policy. The support of the law is important to the accurate implementation of the euthanasia with guidelines to decrease chances of any ethical or legal breach. The individual assessment is important to ensure that there are no chances of any other option to decrease the suffering of the patient. 

Framing

The policy can be an advocate to the public by utilizing the community approach that includes training of the health care professional concerning the right procedure to handle the lifelong illness patient with supporting them during the euthanasia. The other intervention will include educational intervention that is important to address the lack of knowledge of the population concerning the advantage and disadvantage of the euthanasia. The educational intervention will include all the necessary information concerning the euthanasia and its pros or cons. The better understanding of the population will help to improve the decision-making process concerning the wish for the euthanasia. Both of the aspects of the intervention will help to improve the public acceptance of the policy that is necessary for the proper implementation and use of euthanasia to deal with the suffering of the population.

Conclusion on Voluntary Assisted Dying Policy

The rising rate of lifelong illness increased the suffering of the patient that needs to be addressed to decrease the pain and complication of the patient. The increased complication can only be addressed by the euthanasia that has been surrounded by multiple ethical complications. The policy is framed to address the legal and ethical complication associated with the euthanasia by improving the guidelines that are necessary for decreasing the suffrage of the patient. Three aspects will be addressed by the policy which includes workforce knowledge, legislative assistances and patient assessment to improve the implementation of the euthanasia. There are both aspects that are discussed concerning the use of euthanasia and some of the positive aspects are end to suffering, death with dignity and improve patient autonomy. Some of the cons that have been discussed concerning the implementation of the euthanasia devalue human life, opposition from state legislative and personal interest led to euthanasia. The policy is considered to be best from the currently implemented policy due to its holistic approach to deal with the gap in the implementation of the euthanasia. The policy guidelines can reach to the voting public by educational intervention so that they can understand the advantage and disadvantage of the euthanasia. Training od the health care professional is also important as they are directly associated with the patient care which leads to greater impact over the decision of the individual concerning the wish for euthanasia

References for Voluntary Assisted Dying Policy

Abohaimed, S., Matar, B., Al-Shimali, H., Al-Thalji, K., Al-Othman, O., Zurba, Y. & Shah, N. (2019). Attitudes of physicians towards different types of euthanasia in Kuwait. Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre28(3), 199–207. DOI: 10.1159/000497377

Annadurai, K., Danasekaran, R. & Mani, G. (2014). ‘Euthanasia: Right to die with dignity’. Journal of Family Medicine and Primary care, 3, 477-478. DOI: 10.4103/2249-4863.148161.

Banović, B. & Turanjanin, V. (2014). Euthanasia: murder or not: A comparative approach. Iranian Journal of Public Health43(10), 1316–1323.

Barry, L., Hobbins, A., Kelleher, D., Shah, K., Devlin, N., Goni, J. M. R. & O’Neill, C. (2018). Euthanasia, religiosity and the valuation of health states: Results from an Irish EQ5D5L valuation study and their implications for anchor values. Health and Quality of Life Outcomes, 16(152), 1-9. DOI: 10.1186/s12955-018-0985-9 

Boudreau, J. D. & Somerville, M. (2014). Euthanasia and assisted suicide: A physician’s and ethicist’s perspectives. Medicolegal and Bioethics, 1(4), 1-11. DOI:10.2147/mb.s59303 

Braverman, D. W., Marcus, B. S., Wakim, P. G., Mercurio, M. R. & Kopf, G. S. (2017). Health care professionals' attitudes about physician-assisted death: An analysis of their justifications and the roles of terminology and patient competency. Journal of Pain and Symptom Management54(4), 538–545. DOI: 10.1016/j.jpainsymman.2017.07.024

Castro, M. P. R. de, Antunes, G. C., Marcon, L. M. P., Andrade, L. S., Rückl, S., & Andrade, V. L. Â. (2016). Eutanásia e suicídio assistido em países ocidentais: Revisão sistemática. Revista Bioética, 24(2), 355–367. DOI:10.1590/1983-80422016242136 

Catford, J. (2018). Healthy dying: time for health promotion to get serious, Health Promotion International, 33(2), 183–186, https://doi.org/10.1093/heapro/day019

Centre for Disease Control and Prevention. (2015). CDC Policy Process. Retrieved from: https://www.cdc.gov/policy/analysis/process/index.html

Chinitz, D. (2019). The more health policies change, the more they change the same way. Israel Journal of Health Policy Research8(36), 1-5. DOI: 10.1186/s13584-019-0308-6

Clancy, C. M., Glied, S. A. & Lurie, N. (2012). From research to health policy impact. Health Services Research47(2), 337–343. DOI: 10.1111/j.1475-6773.2011.01374.x

Evenblij, K., Pasman, H.R.W. & Van der Heide, A. (2019). Factors associated with requesting and receiving euthanasia: A nationwide mortality follow-back study with a focus on patients with psychiatric disorders, dementia, or an accumulation of health problems related to old age. BMC Med, 17, 39 DOI: 10.1186/s12916-019-1276-y

Goligher, E. C., Ely, E. W., Sulmasy, D. P., Bakker, J., Raphael, J., Volandes, A. E., Patel, B. M., Payne, K., Hosie, A., Churchill, L., White, D. B. & Downar, J. (2017). Physician-assisted suicide and euthanasia in the ICU: A dialogue on core ethical issues. Critical Care Medicine45(2), 149–155. DOI: 10.1097/CCM.0000000000001818`A

 Inbadas, H., Zaman, S., Whitelaw, S. & Clark, D. (2017). Declarations on euthanasia and assisted dying. Death Studies, 41(9), 574-584, DOI: 10.1080/07481187.2017.1317300

Kalal, N. (2019). Review article on euthanasia. International Journal of Current Research, 10(11), 75543-75546. DOI: 10.24941/ijcr.32801.11.2018.

Kanniyakonil, S. (2018). New developments in India concerning the policy of passive euthanasia. Developing World Bioethics, 18(2), 190–197. DOI:10.1111/dewb.12187 

Kouwenhoven, P., van Thiel, G., van der Heide, A., Rietjens, J. & van Delden, J. (2019). Developments in euthanasia practice in the Netherlands: Balancing professional responsibility and the patient's autonomy. The European Journal of General Practice25(1), 44–48.DOI: 10.1080/13814788.2018.1517154

Pereira J. (2011). Legalizing euthanasia or assisted suicide: The illusion of safeguards and controls. Current Oncology (Toronto, Ont.)18(2), e38–e45. DOI: 10.3747/co.v18i2.883

Richards, N. (2017). Assisted suicide as a remedy for suffering? The end-of-life preferences of british “suicide tourists”. Medical Anthropology, 36(4), 348-362, DOI: 10.1080/01459740.2016.1255610

Shuriye, A. O. (2012). Ethical and religious analysis on euthanasia. IIUM Engineering Journal12(5), 209-211. DOI: 10.31436/iiumej.v12i5.261

Sinha, V. K., Basu, S. & Sarkhel, S. (2012). Euthanasia: An Indian perspective. Indian Journal of Psychiatry54(2), 177–183. DOI: 10.4103/0019-5545.99537

Tuffrey-Wijne, I., Curfs, L., Finlay, I., & Hollins, S. (2018). Euthanasia and assisted suicide for people with an intellectual disability and/or autism spectrum disorder: An examination of nine relevant euthanasia cases in the Netherlands (2012-2016). BMC Medical Ethics19(1), 17. DOI: 1186/s12910-018-0257-6

Young, J., Egan, R., Walker, S., Graham-DeMello, A. & Jackson, C. (2019). The euthanasia debate: Synthesising the evidence on New Zealander's attitudes. Kōtuitui: New Zealand Journal of Social Sciences Online, 14(1), 1-21, DOI: 10.1080/1177083X.2018.1532915

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