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From legalisation to practice: implementation of newly legalised health interventions in healthcare settings – a systematic review

Maryam Vizheh, Klay Lamprell, Samran Sheriff, Michaela Cormack, Jeffrey Braithwaite, Karinne Ludlow, Catherine Mills, Janet C. Long

BMJ Open, 2026

56 participants

Abstract

OBJECTIVES: Over the last decade, a growing number of health interventions (eg, medical assistance in dying and mitochondrial donation) have become legalised or decriminalised globally. Newly legalised health interventions share characteristics that are distinct from other health interventions, making their implementation more challenging. They are often highly emotive, controversial and associated with strong opinions and ethical dilemmas, with some of them being high-stake and irreversible. This study aimed to identify, systematise and map the factors that affect the implementation of health interventions that have recently been legalised. DESIGN: A systematically conducted review. DATA SOURCES: PubMed, Scopus, EMBASE and CINAHL were searched to identify studies published between 2014 and 2024. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included studies if they evaluated the implementation of health interventions that were newly legalised or newly decriminalised. DATA EXTRACTION AND SYNTHESIS: Data were extracted and synthesised through descriptive analysis. Both deductive and inductive thematic analyses were applied to map the barriers, facilitators and implementing strategies that influence the implementation of newly legalised health interventions in healthcare settings. RESULTS: The search strategy yielded 1510 publications, of which 78 were included in this review. Findings showed that several newly legalised health interventions, including medical assistance in…

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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 56 participants or records.

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