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  1. Factors influencing practitioners’ who do not participate in ethically complex, legally available care: scoping review.Mary Chipanshi, Alexandra Hodson, Lilian Thorpe, Donna Goodridge & Janine Brown - 2021 - BMC Medical Ethics 22 (1):1-10.
    BackgroundEvolving medical technology, advancing biomedical and drug research, and changing laws and legislation impact patients’ healthcare options and influence healthcare practitioners’ (HCPs’) practices. Conscientious objection policy confusion and variability can arise as it may occasionally be unclear what underpins non-participation. Our objective was to identify, analyze, and synthesize the factors that influenced HCPs who did not participate in ethically complex, legally available healthcare.MethodsWe used Arksey and O’Malley’s framework while considering Levac et al.’s enhancements, and qualitatively synthesized the evidence. We searched (...)
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  • Spanish regulation of euthanasia and physician-assisted suicide.Tamara Raquel Velasco Sanz, Pilar Pinto Pastor, Beatriz Moreno-Milán, Lydia Frances Mower Hanlon & Benjamin Herreros - 2022 - Journal of Medical Ethics 49 (1):49-55.
    In March 2021, the Spanish Congress approved the law regulating euthanasia, that regulates both euthanasia and physician-assisted suicide (PAS). In this article, we analyse the Spanish law regulating euthanasia and PAS, comparing it with the rest of the European laws on euthanasia and PAS (Netherlands, Belgium and Luxembourg). Identified strengths of the Spanish law, with respect to other norms, are that it is a law with many safeguards, which broadly recognises professionals’ right to conscientious objection and the specification that it (...)
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  • Anticipated impacts of voluntary assisted dying legislation on nursing practice.Jessica T. Snir, Danielle N. Ko, Bridget Pratt & Rosalind McDougall - 2022 - Nursing Ethics 29 (6):1386-1400.
    Background: The Voluntary Assisted Dying Act 2017 passed into law in Victoria, Australia, on the 29 November 2017. Internationally, nurses have been shown to be intimately involved in patient care throughout the voluntary assisted dying process. However, there is a paucity of research exploring Australian nurses’ perspectives on voluntary assisted dying and, in particular, how Victorian nurses anticipate the implementation of this ethically controversial legislation will impact their professional lives. Objectives: To explore Victorian nurses’ expectations of the ethical and practical (...)
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  • Conscientious participants and the ethical dimensions of physician support for legalised voluntary assisted dying.Jodhi Rutherford - 2021 - Journal of Medical Ethics 47 (12):e11-e11.
    The Australian state of Victoria legalised voluntary assisted dying in June 2019. Like most jurisdictions with legalised VAD, the Victorian law constructs physicians as the only legal providers of VAD. Physicians with conscientious objection to VAD are not compelled to participate in the practice, requiring colleagues who are willing to participate to transact the process for eligible applicants. Physicians who provide VAD because of their active, moral and purposeful support for the law are known as conscientious participants. Conscientious participation has (...)
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  • Shades of gray: Conscientious objection in medical assistance in dying.Barbara Pesut, Sally Thorne & Madeleine Greig - 2020 - Nursing Inquiry 27 (1):e12308.
    With the advent of legalized medical assistance in dying [MAiD] in Canada in 2016, nursing is facing intriguing new ethical and theoretical challenges. Among them is the concept of conscientious objection, which was built into the legislation as a safeguard to protect the rights of healthcare workers who feel they cannot participate in something that feels morally or ethically wrong. In this paper, we consider the ethical complexity that characterizes nurses' participation in MAiD and propose strategies to support nurses' moral (...)
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  • Becoming a medical assistance in dying (MAiD) provider: an exploration of the conditions that produce conscientious participation.Allyson Oliphant & Andrea Nadine Frolic - 2021 - Journal of Medical Ethics 47 (1):51-58.
    The availability of willing providers of medical assistance in dying in Canada has been an issue since a Canadian Supreme Court decision and the subsequent passing of federal legislation, Bill C14, decriminalised MAiD in 2016. Following this legislation, Hamilton Health Sciences in Ontario, Canada, created a team to support access to MAiD for patients. This research used a qualitative, mixed methods approach to data collection, obtaining the narratives of providers and supporters of MAiD practice at HHS. This study occurred at (...)
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  • Too much safety? Safeguards and equal access in the context of voluntary assisted dying legislation.Rosalind McDougall & Bridget Pratt - 2020 - BMC Medical Ethics 21 (1):1-10.
    BackgroundIn June 2019, the Australian state of Victoria joined the growing number of jurisdictions around the world to have legalised some form of voluntary assisted dying. A discourse of safety was prominent during the implementation of the Victorian legislation.Main textIn this paper, we analyse the ethical relationship between legislative “safeguards” and equal access. Drawing primarily on Ruger’s model of equal access to health care services, we analyse the Victorian approach to voluntary assisted dying in terms of four dimensions: horizontal equity, (...)
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  • Junior doctors and conscientious objection to voluntary assisted dying: ethical complexity in practice.Rosalind J. McDougall, Ben P. White, Danielle Ko, Louise Keogh & Lindy Willmott - 2022 - Journal of Medical Ethics 48 (8):517-521.
    In jurisdictions where voluntary assisted dying is legal, eligibility assessments, prescription and administration of a VAD substance are commonly performed by senior doctors. Junior doctors’ involvement is limited to a range of more peripheral aspects of patient care relating to VAD. In the Australian state of Victoria, where VAD has been legal since June 2019, all health professionals have a right under the legislation to conscientiously object to involvement in the VAD process, including provision of information about VAD. While this (...)
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  • “I haven’t had to bare my soul but now I kind of have to”: describing how voluntary assisted dying conscientious objectors anticipated approaching conversations with patients in Victoria, Australia.Louise Anne Keogh & Casey Michelle Haining - 2021 - BMC Medical Ethics 22 (1):1-12.
    BackgroundDealing with end of life is challenging for patients and health professionals alike. The situation becomes even more challenging when a patient requests a legally permitted medical service that a health professional is unable to provide due to a conflict of conscience. Such a scenario arises when Victorian health professionals, with a conscientious objection (CO) to voluntary assisted dying (VAD), are presented with patients who request VAD or merely ask about VAD. The Voluntary Assisted Dying Act 2017 (Vic) recognizes the (...)
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  • An Internalist Pluralist Solution to the Problem of Religious and Ethical Diversity.Victoria S. Harrison - 2012 - Sophia 51 (1):71-86.
    In our increasingly multicultural society there is an urgent need for a theory that is capable of making sense of the various philosophical difficulties presented by ethical and religious diversity—difficulties that, at first sight, seem to be remarkably similar. Given this similarity, a theory that successfully accounted for the difficulties raised by one form of plurality might also be of help in addressing those raised by the other, especially as ethical belief systems are often inextricably linked with religious belief systems. (...)
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  • Institution animal care and use committees need greater ethical diversity.Lawrence Arthur Hansen - 2013 - Journal of Medical Ethics 39 (3):188-190.
    Next SectionIn response to public outrage stemming from exposés of animal abuse in research laboratories, the US Congress in 1985 mandated Institutional Animal Care and Use Committees (IACUCs) to oversee animal use at institutions receiving federal grants. IACUCs were enjoined to respect public concern about the treatment of animals in research, but they were not specifically instructed whether or not to perform ethical cost-benefit analyses of animal research protocols that IACUCs have chosen, with approval contingent upon a balancing of animal (...)
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  • Understanding the Reasons Behind Healthcare Providers’ Conscientious Objection to Voluntary Assisted Dying in Victoria, Australia.Casey M. Haining, Louise A. Keogh & Lynn H. Gillam - 2021 - Journal of Bioethical Inquiry 18 (2):277-289.
    During the debates about the legalization of Voluntary Assisted Dying in Victoria, Australia, the presence of anti-VAD health professionals in the medical community and reported high rates of conscientious objection to VAD suggested access may be limited. Most empirical research on CO has been conducted in the sexual and reproductive health context. However, given the fundamental differences in the nature of such procedures and the legislation governing it, these findings may not be directly transferable to VAD. Accordingly, we sought to (...)
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  • Social determinants of health and slippery slopes in assisted dying debates: lessons from Canada.Jocelyn Downie & Udo Schuklenk - 2021 - Journal of Medical Ethics 47 (10):662-669.
    The question of whether problems with the social determinants of health that might impact decision-making justify denying eligibility for assisted dying has recently come to the fore in debates about the legalisation of assisted dying. For example, it was central to critiques of the 2021 amendments made to Canada’s assisted dying law. The question of whether changes to a country’s assisted dying legislation lead to descents down slippery slopes has also come to the fore—as it does any time a jurisdiction (...)
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