“Not knowing the law can create problems for care provided to patients and their families.”

 A free national training program for clinicians and medical students to learn about end of life law in Australia has launched today. End of Life Law for Clinicians (ELLC) aims to support clinicians with this legal knowledge and caring for patients at the end of life.

Professor of law at Queensland University of Technology (QUT) and a member of QUT’s Australian Centre for Health Law Research, Professor Ben White spoke to Palliative Matters about the new training program and the importance of educating clinicians and medical students about end of life law.

“The training program aims to improve clinicians’ knowledge and awareness of end of life law, and enhance their capacity to manage legal issues in end of life decision-making.

“We hope that the training will enable clinicians to improve their legal knowledge and application of the law in practice, and will help them support their patients, and patients’ families at the end of life,” Professor White said. 

Designed for medical specialists and trainees, junior doctors and medical students, the training was refined after user testing with clinician focus groups.

“From our research, and consultations with clinicians and stakeholders, we identified areas of end of life law that clinicians are most likely to encounter in end of life practice. These include consent and decision-making capacity, Advance Care Planning, withholding and withdrawing treatment, substitute decision-making and providing palliative medication.

The program, funded by the Australian Department of Health under its National Palliative Care Projects initiative, comprises online training modules and national workshops which clarify the law that applies to end of life decision-making.

“Not knowing the law can create problems for care provided to patients and their families. For example, it can lead to treatment being wrongly removed or wrongly given, inadequate pain relief being provided due to legal concerns, and clinical practice that is inconsistent with individuals’ wishes.

“Gaps in legal knowledge also creates risks for clinicians including not following the law, with the potential for civil liability or criminal prosecution. It can lead to doctors practising defensive medicine, and under-palliation of patients. It can also result in poor doctor-patient communication and conflict with patients’ and families, or substitute decision-makers,” Professor White said.

ELLC was developed in in response to findings from earlier empirical research into doctors’ knowledge of the law on withholding and withdrawing life-sustaining medical treatment. The research undertaken by White and Willmott at QUT with colleagues the University of Queensland and Southern Cross University, surveyed doctors from seven specialties in Victoria, New South Wales and Queensland.

 “The results (published in the Medical Journal of Australia in 2014) revealed significant legal knowledge gaps, including uncertainty about how to determine whether an Advance Care Directive is valid, or whether or not to follow a Directive that refuses treatment in cases where treatment is clinically indicated.

“Encouragingly, the survey also revealed strong agreement that the law has a place in medical practice and decision-making, and most respondents were interested in knowing more about the law. This combination of an identified need with an interest in knowing more about law in this area was the impetus for us to develop the training program,” Professor White said.

“The online training modules also address the differences in the laws in all 8 Australian jurisdictions through End of Life Law in Australia, a resource we developed for health professionals and the broader community to find out more on end of life law,” Professor White said.

The training program can be accessed online through the ELLC online portal. The training can also be completed by nurses and allied health professionals. Certificates of completion are available on completion of a module, and CPD points may be available from medical colleges, societies or professional organisations.