Background
Voluntary assisted dying (VAD) legislation came into effect in South Australia on 31st January 2023. A national survey of Medical Oncology Physicians conducted in 2017 demonstrated 47% of respondents had a philosophical disagreement towards VAD (Karapetis et al. 2018), suggesting patient access to VAD assessments may be impacted by lack of availability of willing clinicians. The aims of this project are to assess Medical Oncologist perception of VAD legislation in South Australia at its inception, quantify willingness and identify barriers to participation in VAD activities/assessments.
Methods
A survey was developed and circulated electronically to Medical Oncology Consultants and Advanced Trainees currently practicing in South Australia. Responses were anonymised and analysed in aggregate using SPSS Version 27 software.
Results
Throughout May 2023, 41 responses were received from 67 invited participants (61% response rate). The rate of conscientious objection to VAD was 22% (9/41). Among non-conscientious objectors, lack of time was the most important barrier to participation (reported as the top barrier by 50% or 16/32 of respondents). The most important motivation for participation was beneficence (alleviation of suffering), ranked as the top motivation by 47.6% (10/21) of respondents. A total of 22% (9/41) reported a willingness to participate in VAD activities in the future and an additional 24.4% (10/41) are unsure whether they would be willing to participate. Mandatory training has been completed by 17.1% (7/41) of respondents and an additional 19.5% (8/42) intend to undertake training within the next 2 years.
Conclusions
The rate of conscientious objection was lower than expected based on national surveys conducted prior to implementation of VAD in Australia. This study highlights physician reported barriers to participation in VAD activities, including lack of time and remuneration. Policies to address these factors are likely to improve accessibility of VAD to eligible patients.