Dr Ann Gallagher

Biography

Ann  has extensive experience as a healthcare ethicist, nurse, educator, researcher & editor (of the international journal 'Nursing Ethics').
She is Chair of the University of Surrey Ethics Committee, a member of the RCN Ethics Committee, the SE NHS Research Ethics Committee and of clinical ethics committees working with practitioners to resolve ethical challenges in everyday practice. She is also a Stakeholder Governor of a NHS Trust

Research Interests

.The current focus of her research relates to understanding and responding to deficits in care, dignity in care, professionalism, end of life ethics and research ethics. Ann has published on a wide range of topics in healthcare ethics, for example, on restraint, whistleblowing and conflicts of interest. She is co-author of 'Nursing and Human Rights' (with Jean McHale) and 'Ethics in Professional Life: Virtues for Health and Social Care' (with Sarah Banks). She is co-editor of 'Ethical, Legal and Professional Aspects of Healthcare: A practice-based approach' (with Sue Hodge 2012).

Recent publications include:
Media - http://www.guardian.co.uk/healthcare-network/2012/may/10/nursing-should-tackle-image-problem
Gallagher A., Wainwright P., Tompsett H. & Atkins C.(2012) Findings from a Delphi Study regarding Conflicts of Interest, General Practice and Safeguarding Children: Listen Carefully, Judge Slowly Journal of Medical Ethics Vol. 38 pp. 87-92
Gallagher A. (2011) Moral Distress and Moral Courage in everyday Nursing Practice Online Journal of Issues in Nursing  Vol.16, No.2
Gallagher A. & Gannon C. (2011) Difficult Decisions in Cancer Care – Conducting an Ethics Case Analysis European Oncology & Haematology 7 (2) pp.101-105
Gallagher A. (2011) Ethical issues in patient restraint Nursing Times Vol. 107, No. 9. pp, 18-20
Gallagher A. (2010) Whistleblowing: what influences nurses on whether to report poor practice? Nursing Times 106 (4), pp.22-25
Gallagher A. (2010) Have you thought about assisted suicide? NMC News Issue 31, pp. 12-13

Research Collaborations

RESEARCH REPORTS

Evaluation of the RCN Dignity Campaign – ‘The Little Things Make a Difference’ (2009) – co-authored with Lesley Baillie

‘Receiving bad news about your mental health’ pilot research project (2008) – A collaborative project with Anne Arber, University of Surrey and Rob Chaplin and Alan Quirke, Royal College of Psychiatrists.

‘The Good Nurse: UK Pilot Study’ (2008) – A replication of the Far East Good Nurse Project with Khim Horton, Verena Tschudin and Sara Lister

‘Defending Dignity – Challenges and Opportunities’ (2008) – commissioned to develop e-survey, analyse data, write report and contribute to the development of educational materials with Professor Paul Wainwright and Dr Lesley Baillie.

Conflicts of Interests, General Practitioners and Safeguarding Children research project report (Tompsett et al 2008) - funded by the Department for Education and Skills & Department Health ‘Safeguarding Children Research Initiative’ – Co-researcher with social work and health colleagues at Kingston University and St George’s University of London – member of project management team and lead on designing, implementing and analysing Delphi Expert panel component

‘Arts for Life’ report (2007) - patients’ and carers’ perceptions of the value of the arts in palliative care – Commissioned by St Christopher’s Hospice. Awaiting publication in Nursing Standard.

‘Complementing the Community Project’ report (2007) relating to the perceived benefits of complementary therapies by those with non -malignant conditions – Commissioned by St Christopher’s Hospice.

Dignity in Practice Pilot Project Report (2001) with Professor David Seedhouse at Middlesex University.

Publications

Teaching

Ann is module leader for post-graduate module ‘Professional Ethics in a Global Context’ – this provides opportunities for UK and international professionals and students to enhance their understanding of professional ethics and to share experiences of working in complex and ever-changing cultural, political and policy contexts

She teaches ethics to undergraduate health processionals (nurses, midwives, paramedics, and operating department attendants. 

Departmental Duties

- Chair of University Ethics Committee 

-Developing research proposals, applying for funding and conducting empirical research relating to healthcare ethics
- Writing and publishing in peer-reviewed and professional journals
- Leading staff development in relation to teaching healthcare ethics

- Lead on nursing research collaboration with University of Sao Paulo, Brazil
- Developing international research and scholarship collaborations through the International Centre of Nursing Ethics (ICNE)
- Editor of international journal Nursing Ethics
- Teaching ethics to undergraduate and post-graduate students
- Supervising MSc, DCP and PhD students undertaking ethics-related research

Death on Prescription?

The Commission on Assisted Dying provides an impetus for reflection and critical debate

If you or a family member were terminally ill, would you like your GP to have the option of prescribing a lethal dose of medication? What if your diagnosis or prognosis was incorrect? Might you be concerned that a disabled or elderly person might feel pressurised to opt for assisted dying should it become available? Perhaps you think it abysmal that some UK citizens have to travel to Dignitas in Switzerland to avail of assisted death? Or, perhaps, you think that we should not allocate scarce healthcare resources to those who are terminally ill….? The recent report from the Commission on Assisted Dying requires that we engage with, and consider our responses to, these and other challenging questions relating to end of life choices. (See http://www.demos.co.uk/publications/thecommissiononassisteddying ).

The Commission considered ‘that the current legal status of assisted suicide is inadequate and incoherent’. It concludes that there is ‘a strong case for providing the choice of assisted dying for terminally ill people.’ Following an extensive consultation process and visits to regions that permit assisted dying (Oregon, the Netherlands, Belgium and Switzerland) the Commission proposed a framework that would, should assisted dying be legalised, provide ‘safeguarded access to assisted dying for eligible people’.

People considered eligible must be: over 18 years old; have a diagnosis of a terminal illness; make a voluntary choice; and have the mental capacity required to make such a choice. Safeguards include a decision-making model involving the independent judgements of two doctors (with support from other health and social care professionals) and processes to ensure the person is fully informed of treatment and care options, that he/she has capacity, that the lethal medication is transported and stored safely and that the assisted death is properly supported and recorded.

The ethical arguments for and against assisted suicide are discussed in some detail in Chapter 2 of the report and supported by data from evidence submitted to the Commission. These arguments relate to individual autonomy, the value and sanctity of life, compassion, the protection of vulnerable people, the balance of harms, non-discrimination in law and policy and, what is referred to as, medical ethics. Under the latter heading, the report discusses ‘the prohibition on doctors ending life’ and ‘the doctor’s role in relieving suffering’ (p.85).

The report has, understandably, generated a lot of controversy and debate. It urges us to consider questions we would probably rather ignore. Death and dying continue to be taboo topics and few people are willing or able to discuss them openly. The Commission’s report offers the opportunity to engage with these topics critically and constructively. Adopting an ostrich-like approach is not an option in educational programmes for health professionals and we need to consider additional and crucial questions. These would relate to, for example, the role of nurses and allied professionals should assisted dying be legalised, how conscientious objection would be operationalised; and what would constitute adequate educational preparation for nurses and other professionals should assisted dying be legalised? Professional education is directed not only towards the prevention of ill-health and the promotion of health but also towards helping people live well until they die. The School of Health and Social Care at the University of Surrey, in collaboration with our local hospices and hospitals, already offers an exemplary range of palliative care educational provision.

The debate about assisted dying is not, in my view, going to subside and we need to consider the very real possibility that in the years to come it will be legalised in the UK. Health professionals currently have to give a good deal of thought to how they balance respect for patient autonomy with the values of not doing harm, of doing good and treating people fairly. Should assisted dying be legalised in the future, the most pressing imperative for health professionals must be to protect, and advocate for, the most vulnerable individuals and groups. Professionals must also have the resources required to continue to deliver dignifying end of life care and the opportunity to opt out of assisted dying should this conflict with their personal and professional values.

Dr Ann Gallagher
Reader in Nursing Ethics