Full Citation
Title: Dying, Disability, and Dangerous Decisions: Protecting Patient Safety in Assisted Dying in England and Wales
Citation Type: Journal Article
Publication Year: 2021
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Abstract: Copious academic scholarship has considered legalising assisted dying (AD). However, notwithstanding its obvious importance, safety has been relatively excluded from the AD debate. The debate has now reached an impasse and can arguably be distilled to one bone of contention: "slippery slope" fears. Opponents argue proposed safeguards will be unable to prevent the development of slippery slopes, in which vulnerable populations (namely the mentally ill, dying, and disabled) will be implicitly or explicitly pressured into receiving assistance in dying. Whilst safeguards are a valid field of inquiry, they represent just one facet of safety. Safety is conceived broadly as the prevention of harm, interdependent on timeliness, quality, effectiveness, and access. Whereas safeguards are predominantly concerned with employing preventative, defensive measures to avoid the emergence of harm, patient safety also depends on the improvement of latent conditions and active failures according to Reason's Swiss Cheese Model of safety, which this thesis subscribes to. A myopic focus on safeguards has facilitated the premature and unduly defeatist conclusion that AD and patient safety are mutually exclusive. This thesis seeks to rebut opposition by identifying potential risks to patient safety throughout the AD process and advancing proposals to protect safety under four themes: communication, symptom management, data monitoring, and safety cultures. This dissertation explicitly endorses an overarching focus on patient recovery, achieved via a multidisciplinary approach to symptom management prior to AD authorization. Thoroughly investigating patient motivations behind AD requests is more conducive to patient safety than perfunctory 'safeguards' which restrict eligibility to terminally ill patients with a six-month life expectancy or exclude disabled or mentally ill individuals. Thus, to ensure that AD remains an absolute last resort, several proposals are advanced, including a specific AD statute, a specialist national monitoring committee with regional subdivisions, and ongoing medical AD education.
Url: https://heinonline.org/HOL/LandingPage?handle=hein.journals/bristol2021&div=10&id=&page=
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Authors: Hayes, Louise
Periodical (Full): Bristol Law Review
Issue:
Volume: 2021
Pages: 110-143
Data Collections: IPUMS CPS
Topics: Fertility and Mortality, Health
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