Australian pharmacists’ perspectives on physician-assisted suicide (PAS): thematic analysis of semistructured interviews

Abstract

ObjectivesThis study aimed to investigate Australian pharmacists’ views about their role in physician-assisted suicide (PAS), their ethical and legal concerns and overall thoughts about PAS in pharmacy.DesignSemistructured interviews of pharmacists incorporating a previously validated vignette and thematic analysis.SettingAustralia (face to face or phone call).Participants40 Australian Health Practitioner Regulation Agency registered pharmacists, majority women (65%) with varied experiences in community, hospital, industry, academia, government and other fields.ResultsEmergent themes from the interviews were:legal and logistical framework,ethical framework,training and guidanceandhealthcare budget. More than half the participants supported the role of pharmacists in the supply of medicines for PAS, while less than half were either against or unsure of the legislation of PAS in Australia. Shared concerns included transparency of prescribing practices and identification of authorised physicians involved in PAS, which were consistent with existing literature. Religious faith, emotion and professional autonomy were key indicators for the implementation of conscientious objection to the supply of medicines in PAS. Re-evaluation of current guidelines, pharmacist training and government reimbursement was also of significance from participants’ perspectives.ConclusionThis study revealed current concerns of practising pharmacists in Australia, including previously undocumented perspectives on the pharmacoeconomic impact of and barriers relating to PAS. The need for training of all healthcare professionals involved, the provision of clear guidelines, including regulation around storage, administration and disposal of medicines dispensed for PAS and the updating of current therapeutic guidelines around end-of-life care were all issues delineated by this study. These findings highlighted the need for current and future policies to account for all stakeholders involved in PAS, not solely prescribers.