Table 1 Working towards rapprochement between disparate ethical stances on Assisted Dying in health systems
From: Objections to assisted dying within institutions: systemic solutions for rapprochement
Strategy | The how: what did we actually do? |
|---|---|
Testing the “affect” of the system | We directly sought staff feedback about their feelings about VAD* (i.e. not by generic institutional surveys) |
Naming and reconciling the systemic split | We emphasised and gave permission for the variety of VAD stances in all clinician forums. |
Modelled understanding and respect for ethical tensions created by VAD | We modelled understanding and respect for conscientious objection while emphasising the essential integration of palliative care, both with leaders and across all clinician forums. |
A stance of reasonable accommodation compliant with the legislation | Education about managing personal objection started with leaders first, and was subsequently delivered across the organisation. We disseminated the White et al [1] paper. |
Identifying and addressing undue influence | Openly discussed power imbalances within the organisation. The importance of giving voice to quieter members of the system repeatedly emphasised in multidisciplinary clinician forums |
Peer Support Groups | This was focused on clinicians actively involved in VAD. |