Project

This project will undertake the first comprehensive analysis of how Australian VAD systems are being implemented and are operating in practice. It will also examine the extent to which these laws, as implemented, are meeting their intended policy goals. As it is a multi-jurisdictional project, it will have the unique opportunity to compare VAD operation across different States with different laws, systems and policies. As VAD systems are at a relatively early stage in Australia, it is important to learn more about how VAD is operating in practice, and how current practice can be improved.

Why is this project needed?

While each State VAD Board and Commission obtains case information on VAD for compliance and reporting purposes, there is other important information that falls outside what the Boards have resourcing or power to obtain. This multi-jurisdictional project provides a unique opportunity to establish a comprehensive and rigorous evidence base, generating new data to supplement information collected by State VAD Boards. Analysis of this data will support the ongoing obligation of Boards to monitor and improve practice.

The project will:

  • provide a timely, clear assessment of how the VAD system is operating in practice; and
  • identify what systemic or practical reforms may be needed to achieve the optimal balance between ensuring eligible individuals who choose to access VAD can do so, while ensuring the safeguards operate effectively to deny access to ineligible individuals.

The project will provide impactful and tangible solutions for practice, policy, and law reform to solve real-world challenges in the operation of VAD, and be of wide-ranging national benefit.

What does this project involve?

This project has four stages across three years:

Stage 1 – Analysis of existing Board data: Existing data collected by the VAD Boards and Commission will be analysed to better understand how VAD is operating in practice (including legal, system, policy, and procedural aspects). This stage involves comprehensive analysis of Board data, beyond what currently occurs for compliance and reporting purposes. Board data will provide information on each person who has applied for VAD which can be used to determine VAD activity in each state, including number and type of applicants and progress through the VAD request and administration process.

Stage 2 – Mapping existing evidence: This stage builds on Stage 1 by mapping existing evidence on the current operation of VAD in Australia, aiming to identify and critically analyse what information is currently known or being collected, and gaps in the evidence. Mapping will follow a systematic process and will draw on existing Board data, academic and grey literature, legal sources, reports of State VAD Boards and issues identified by Partner Organisations. Mapping will identify important evidence gaps that could be addressed by this research.

Stage 3 – Generating new evidence about critical knowledge gaps: This stage involves empirical research to address identified gaps in the evidence. Multiple research methods may be employed as appropriate, including qualitative interviews with key stakeholders (including patients and families), to gain a rich understanding of participants’ experiences with VAD. Areas for investigation will be informed by earlier research stages and contributions from Partner Organisations. Areas of investigation may include, for example:

  • drivers of VAD uptake;
  • determinants of administration decisions (self- vs practitioner administration);
  • barriers to VAD uptake by patients;
  • reasons why patients who wish to access VAD may not receive it (e.g. ineligible, could not navigate the process);
  • facilitators and barriers for adopting VAD practice by participating health professionals;
  • State legislative differences and implications for patient access;
  • implications of individual conscientious objection and institutional objection.

Stage 4 – Integration of findings and collaborative strategies: This stage draws together project findings using a socio-legal analysis that synthesises the earlier stages of the research and provides a comparative assessment. The team will (1) identify the relevant policy goals, and (2) integrate project findings to critically evaluate the extent to which the VAD laws, as implemented, reflect those policy goals.

This stage also involves the researchers and Partner Organisations collaborating to use the findings to develop strategies to improve practice. Recommendations will be made about health service system changes (e.g. through education, training, policies, structural change etc) and potential areas for future law reform. The project will, if relevant, identify any local or State-based innovations that should be supported for improved implementation.

Partner Organisations

We will collaborate with the following Partner Organisations:

PhD scholarships

There are opportunities to undertake PhD study as part of this project. Because the project is interdisciplinary, applications are welcome from a range of disciplines including law, regulation, social science, bioethics and health/public policy.

For additional information on PhD opportunities, please contact Professor Ben White.