The Australian College of Nursing (ACN) has welcomed the new Dying with Dignity Bill, but also recommends that greater consideration be given to the role of nurses in end-of-life care, and the context and settings in which dying with dignity services are provided, in the Medical Services (Dying with Dignity) Exposure Draft Bill 2014.
The objective of the proposed Bill is “to recognise the right of a mentally competent adult who is suffering intolerably from a terminal illness to request a medical practitioner to provide medical services that allow the person to end his or her life peacefully, humanely and with dignity” (Section 3 (a)).
ACN has recommended that the proposed Bill provide greater detail and clearer definitions in a number of areas of the Bill. What constitutes a ’dying with dignity medical service’ is not clear in the Bill. The distinction between a ‘terminal illness’ and a ‘chronic condition’ is not clear and a number of terms used such as ‘extraordinary measures’ remain undefined.
ACN has also highlighted that the draft Bill is silent on the context and environment in which a ‘dying with dignity medical service’ may be provided and the requirements specific to particular settings.
Adjunct Professor Debra Thoms, CEO of ACN, said that the proposed Bill refers to medical practitioners, yet the care of terminally ill patients is usually delivered by multidisciplinary health care teams. The Bill is silent on the role of health practitioners other than medical practitioners in the delivery of dying with dignity medical services.
“Nurses are significant members of these teams providing 24 hour care. When caring for a terminally ill patient, it is a nurse’s role to explore with the patient and his/her significant others the patient’s wishes for end-of-life care and to provide information and counselling about options. ACN suggests that this role has not been given due consideration in the drafting of the Bill,” said Adjunct Professor Thoms.
In ACN’s view, the Draft Exposure Bill would benefit from further, extensive consultation with health care professionals and the community. ACN recommends that much greater consideration be given to the details contained within the Bill as well as the Bill’s implications for health care professionals and for the community.