Beardsley Christian, Brown Kilian, Sandroussi Charbel
Department of Upper GI Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Surgical Outcomes Research Centre, Sydney, New South Wales, Australia.
ANZ J Surg. 2018 Oct;88(10):956-958. doi: 10.1111/ans.14513. Epub 2018 May 14.
Surgeons play a significant role in the treatment of patients with many types of cancer, including the management of advanced and recurrent disease after long periods of apparent remission. The recently introduced Victorian Voluntary Assisted Dying (VAD) Act represents a shift in paradigm in Australian medical practice. To be eligible for VAD, the new legislation requires patient assessment by a physician with at least 5 years post-fellowship experience and relevant expertise in the patient's condition. Given many specialist surgeons' experience in managing advanced and often incurable malignancy, it is likely that many will receive referrals for assessment for VAD. It is foreseeable that other states and territories in Australia will follow suit with similar legislation. It is imperative that surgeons receiving referrals to assess patients seeking access to VAD are familiar with the legislation and assessment process. This article summarizes the current regulation of VAD in Australia, including the patient application and assessment process, briefly reviews world-wide assisted dying practices and discusses the relevance to surgeons practicing in Australia.
外科医生在多种癌症患者的治疗中发挥着重要作用，包括对经过长时间明显缓解后的晚期和复发性疾病的管理。最近出台的维多利亚州自愿协助死亡（VAD）法案代表了澳大利亚医疗实践中的范式转变。要符合VAD的条件，新立法要求由一名具有至少5年 Fellowship 后经验且在患者病情方面具有相关专业知识的医生对患者进行评估。鉴于许多专科外科医生在管理晚期且往往无法治愈的恶性肿瘤方面的经验，很可能许多外科医生会收到VAD评估的转诊。可以预见，澳大利亚的其他州和领地将效仿出台类似立法。接受转诊以评估寻求VAD的患者的外科医生必须熟悉相关立法和评估程序。本文总结了澳大利亚目前对VAD的监管情况，包括患者申请和评估程序，简要回顾了全球范围内的协助死亡做法，并讨论了其与在澳大利亚执业的外科医生的相关性。
