Better Regulation of End-Of-Life Care: A Call For A Holistic Approach

Existing regulation of end-of-life care is flawed. Problems include poorly-designed laws, policies, ethical codes, training, and funding programs, which often are neither effective nor helpful in guiding decision-making. This leads to adverse outcomes for patients, families, health professionals, and the health system as a whole. A key factor contributing to the harms of current regulation is a siloed approach to regulating end-of-life care. Existing approaches to regulation, and research into how that regulation could be improved, have tended to focus on a single regulatory instrument (e.g., just law or just ethical codes). As a result, there has been a failure to capture holistically the various forces that guide end-of-life care. This article proposes a response to address this, identifying regulatory space theory as a candidate to provide the much-needed holistic insight into improving regulation of end-of-life care. The article concludes with practical implications of this approach for regulators and researchers.

Automated summary

Existing regulation of end-of-life care is flawed, with poorly-designed laws, policies, and training programs leading to adverse outcomes. Current approaches to regulation tend to focus on a single instrument, neglecting the various forces that guide end-of-life care. This article proposes the use of regulatory space theory to provide a holistic insight into improving regulation, with practical implications for regulators and researchers.