Medical education and law: withholding/withdrawing treatment from adults without capacity

Parker, M., Willmott, L., White, B., Williams, G. and Cartwright, C. (2015) Medical education and law: withholding/withdrawing treatment from adults without capacity. Internal Medicine Journal, 45 6: 634-640. doi:10.1111/imj.12759

Author Parker, M.
Willmott, L.
White, B.
Williams, G.
Cartwright, C.
Title Medical education and law: withholding/withdrawing treatment from adults without capacity
Journal name Internal Medicine Journal   Check publisher's open access policy
ISSN 1445-5994
Publication date 2015-06
Sub-type Article (original research)
DOI 10.1111/imj.12759
Volume 45
Issue 6
Start page 634
End page 640
Total pages 7
Place of publication Richmond, VIC Australia
Publisher Wiley-Blackwell Publishing Asia
Collection year 2016
Language eng
Formatted abstract
Background: Law is increasingly involved in clinical practice, particularly at the end of life, but undergraduate and postgraduate education in this area remains unsystematic. We hypothesised that attitudes to and knowledge of the law governing withholding/withdrawing life-sustaining treatment from adults without capacity (the WWLST law) would vary and demonstrate deficiencies among medical specialists.
Aims: We investigated perspectives, knowledge and training of medical specialists in the three largest (populations and medical workforces) Australian states, concerning the WWLST law.
Methods: Following expert legal review, specialist focus groups, pre-testing and piloting in each state, seven specialties involved with end-of-life care were surveyed, with a variety of statistical analyses applied to the responses.
Results: Respondents supported the need to know and follow the law. There were mixed views about its helpfulness in medical decision-making. Over half the respondents conceded poor knowledge of the law; this was mirrored by critical gaps in knowledge that varied by specialty. There were relatively low but increasing rates of education from the undergraduate to continuing professional development (CPD) stages. Mean knowledge score did not vary significantly according to undergraduate or immediate postgraduate training, but CPD training, particularly if recent, resulted in greater knowledge. Case-based workshops were the preferred CPD instruction method.
Conclusions: Teaching of current and evolving law should be strengthened across all stages of medical education. This should improve understanding of the role of law, ameliorate ambivalence towards the law and contribute to more informed deliberation about end-of-life issues with patients and families.
Keyword Education
Terminal care
Medical law
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Public Health Publications
School of Medicine Publications
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