National Advance Care Planning Week gives us all an opportunity to reflect on the state of end-of-life care in our part of the world. For us, as health lawyers, this means the law that governs end-of-life decision-making. What is working? What isn’t? How we can work collaboratively to improve awareness of advance care planning and support patient choices to be respected?
Law’s role in advance care planning and end-of-life care
One part of advance care planning that is often unseen is law. Yet law plays an important role in end-of-life care. It provides legal force and recognition for a person being able to refuse treatment and it also facilitates consent to that treatment, including through advance care planning documentation. As such it supports patients to make their own decisions – including those that others might disagree with. Law also establishes the legal framework for family members and others to make decisions on behalf of loved ones as substitute decision-makers.
We are not suggesting that law is at the centre of clinical encounters. But failure to see law’s role misses this important structural contribution to decision-making in this area, which risks opportunities to do better at advance care planning.
A new project to support health professionals’ legal knowledge
We recently completed a 3-year Australian Research Council-funded study which found that doctors’ have significant legal knowledge gaps in this area. Another important finding from that work was that doctors want to know more about this area of law.
Prompted by these results, we and colleagues recently secured funding from the Commonwealth Department of Health to design and implement a legal education training program. Although legal knowledge of all health professionals is important, this project begins with the issues identified in our earlier research and focuses on doctors.
The program will provide resources for medical specialists (including GPs), interns and registrars, and medical students. It will be rolled out next year and will include a series of online modules as well as workshops held in all States and Territories.
Module topics include advance care directives, substitute decision-making, palliative medication, futile or non-beneficial treatment, emergency treatment, end-of-life decision-making for children, and resolving disputes. There is also a module which explains the law that plays a role in end-of-life care.
We mentioned collaboration in the opening paragraph of this blog and this project too must be a collaborative one. We are in the process of developing these training modules and workshop materials and welcome the thoughts and ideas of those who might ultimately use them. This includes not only individual health professionals and students but also the organisations who support them including medical colleges and societies, hospitals and health facilities, medical schools and health departments. We provide the contact details of the Project Manager below if you have ideas about this work and want to get in touch.
End-of-life resources available now
This training program will not be ready until next year. However, there is an existing resource that you might find helpful: the End of Life Law in Australia website. We produced this website in response to the research project we mentioned above to help interested health professionals find out more about the law in this area. Our goal was to try and provide a comprehensive and accessible statement of end-of-life law across all 8 Australian jurisdictions. The website covers issues such as the law governing palliative care, advance directives, withholding or withdrawing treatment, assisted dying and organ and tissue donation.
As National Advance Care Planning Week focuses us on engaging in end-of-life conversations – both in the public domain and on an individual level – we note the role that law plays in this area. We encourage those involved to know how law can support advance care planning, and to become familiar with how the law works in your State or Territory. The more we know and understand the process, the more we can support others to plan for their future.
Professor Ben White, Director, Australian Centre for Health Law Research, Faculty of Law, QUT
Professor Lindy Willmott, Director, Australian Centre for Health Law Research, Faculty of Law, QUT
Project Managers Details:
National Palliative Care Projects
Australian Centre for Health Law Research, QUT
Ph. 07 3138 2230