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INTRODUCTION
Voluntary Assisted Dying (VAD) was legalised in Victoria in 2017, in WA in 2019, with other states and territories following.1 In clarifying processes and terminology, VAD in Australia refers to someone with advanced disease taking medication prescribed by a doctor who will bring about their death at a time they choose.1 This is similar to Medical Aid in Dying (MAiD) which is enacted in the USA and Canada.2 Euthanasia, however, is where someone (a doctor for example) intentionally administers a fatal dose of medication at the patients' request.3 These acts have the intention of purposefully ending someone's life.
Life rituals are practised in most countries around the globe, described as "a sequence of activities involving gestures, words, and objects performed in a specific place and sequence of time. Rituals encase memories and link the past with the present".4(p471)
Rituals can be found in birth, in coming of age and marriage, as well as at the end of life, with funerals and memorial services marking the ultimate rite of passage.5 A team of researchers interviewed Canadian nurses on good nursing practice surrounding MAiD, with the concept of ritual emerging as something nurses felt was missing and even enacted themselves when appropriate.6 Rituals have a very real place in society and in healthcare (for example, annual memorial services), with nurses playing a vital role.
The VAD law was being introduced in Australia at the same time as a team at Flinders University were hosting a Massive Open Online Course (MOOC) on Death and Dying called 'Dying2Learn'.7
The MOOC was freely available and targeted at the general public to introduce dying as a normal part of life, and to encourage open conversations. It was proposed that participants were asked about their thoughts on the possibility of new rituals emerging in relation to VAD being performed. In the 2018 MOOC we included an activity that looked at the social side of VAD, which aligned with the MOOC philosophy and approach of promoting socially constructed learning and conversation, rather than a medically focused curriculum.7
METHODS
This work is taken from the Dying2Learn Massive Open Online Course (MOOC), hosted four times by the CareSearch project. Ethics approval related to the Dying2Learn MOOC was granted by the Flinders University Research Ethics...