A Canadian Academic Hospital’s Initial MAID Experience: A Health-Care Systems Review

Ball, Ian; Hodge, Brent; Jansen, Sandy; Nickle, Susan E; Sibbald, Robert

doi:10.1177/0825859718812446

Cited by 26 publications

(34 citation statements)

References 4 publications

(4 reference statements)

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“…Over 75% of these individuals had an underlying primary diagnosis of malignancy, with a smaller proportion having cardiorespiratory (11%) and neurodegenerative diseases (5%). This distribution of patients' primary diagnosis is similar to other Ontario MAiD programs 15,16 though with a greater emphasis on cancer diagnoses as compared to Ontario-wide MAiD statistics 18 and the British Columbia statistics, 19 which is likely a reflection of our organization's status as a regional cancer center. Our data are also consistent internationally with that reported from several US states, [9][10][11][12][13]21 Switzerland 20 Belgium, and the Netherlands.…”

Section: Discussionsupporting

confidence: 59%

“…Several of these jurisdictions have published data detailing their experiences with assisted dying [8][9][10][11][12][13][14] including demographic statistics and reasons cited for choosing hastened death. While other Canadian centers have documented their steps in developing local infrastructure to support MAiD requests and the delivery of MAiD, [15][16][17] there remains a paucity of published data describing the demographic characteristics of Canadians requesting MAiD and the outcomes of such requests. Our study was designed to provide expanded information on patients requesting MAiD, gathering data from the time of request through to either completion of MAiD or a finding of ineligibility.…”

Section: Introductionmentioning

confidence: 99%

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Medical Assistance in Dying (MAiD): A Descriptive Study From a Canadian Tertiary Care Hospital

Debbie

Bean

Isenberg‐Grzeda

et al. 2019

Am J Hosp Palliat Care

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Background: In June 2016, the Government of Canada passed Bill C-14 decriminalizing medically assisted death. Increasing numbers of Canadians are accessing medical assistance in dying (MAiD) each year, but there is limited information about this population. Objective: To describe the characteristic outcomes of MAiD requests in a cohort of patients at an academic tertiary care center in Toronto, Ontario, Canada. Methods: A retrospective chart review of patients making a formal request for a MAiD eligibility assessment from July 16 to September 18. Data extracted included demographics, diagnosis, psychosocial characteristics, information relating to the MAiD request, and clinical outcome. Results: We received 107 formal requests for MAiD assessment. Ninety-seven patients were found eligible, of whom 80 received MAiD. Cancer was the primary diagnosis for 78% and median age was 74 years. The majority of patients (64%) cited “functional decline or inability to participate in meaningful activities” as the main factor motivating their request for MAiD. Half of patients who received MAiD (46%) described their request as consistent with a long-standing, philosophical view predating their illness. The 10-day reflection period was reduced for 39% of provisions due to impending loss of capacity. Our cohort was very similar demographically to those described both nationally and internationally. Conclusion: Patients seeking MAiD at our institution were similar to those described in other jurisdictions where assisted dying is legal and represent a group for whom autonomy and independence is critical. We noted a very high rate of risk of loss of capacity, suggesting a need for both earlier assessments and regular monitoring.

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Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Medical Assistance in Dying (MAiD): A Descriptive Study From a Canadian Tertiary Care Hospital

Debbie

Bean

Isenberg‐Grzeda

et al. 2019

Am J Hosp Palliat Care

View full text Add to dashboard Cite

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“…[4 ss17,26] However, while mandatory training on the Act ensures that medical practitioners have a sound understanding of the law, the effective provision of VAD services will inevitably require a multidisciplinary team. [23] Nurses will play an important role in supporting other healthcare practitioners and patients navigate access to VAD. [24] Nurses also have duties to ensure their own conduct falls within the law.…”

Section: Resultsmentioning

confidence: 99%

Voluntary assisted dying in Victoria: Why knowing the law matters to nurses

Hewitt

White²,

Villar³

et al. 2020

Nurs Ethics

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In 2017, Victoria became the first state in Australia to pass legislation permitting voluntary assisted dying. Under this law, only those people who are near the end of their lives may access voluntary assisted dying, and because many of these people require nursing care to manage the progression of their illness or their symptoms, it will invariably have an impact on nursing practice. The Victorian law includes a series of procedural steps as safeguards to ensure that the law operates as intended. To support people who choose voluntary assisted dying and to practice safely within boundaries of the law, nurses must be aware of these requirements and how they operate. However, there are often gaps in nurses’ legal knowledge. This was demonstrated in an article that aimed to inform nurses about the operation of Voluntary Assisted Dying Act 2017 (Vic) but contained several errors and misstatements of the law. Our article corrects these errors and discusses how the law is intended to be applied by revisiting the fictional case of Chloe – a woman with a terminal illness who is seeking voluntary assisted dying. As the Voluntary Assisted Dying Act 2017 (Vic) also protects nurses from liability if they act in accordance with its provisions, we conclude that sound knowledge and understanding of its operation support nurses to provide the safe, comprehensive and compassionate care their patients deserve at the end of life.

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“…As such, physicians and nurse practitioners specifically and Canadians in general are now faced with the challenge of incorporating and implementing this unprecedented (in Canada) medical procedure 14 and response to it is mixed and likely to remain so. 15 Affording choice at the end of life not only created logistical changes to physicians’ professional practice, it also meant they were confronted with their own value judgements regarding physician-assisted death and to what extent they felt they could be involved in this new legislation.…”

Section: Introductionmentioning

confidence: 99%

Physician snapshot: the forming landscape of MAiD in northwestern Ontario

Durant

Kortes-Miller

2020

Palliat�Care

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Background: Options available to Canadians at the end of life increased with the legalization of medical assistance in dying (MAiD). Bill C-14 modified the Canadian Criminal Code allowing individuals who meet very specific criteria to receive a medical intervention to hasten their death. June 2019 marked 3 years since the legislation has changed and while met with favour from most Canadians who believe it will provide enhanced options for quality of life at the end of life, there remains much debate over both its moral implications and practical components. Little is known regarding the Canadian healthcare provider experience with MAiD, in particular in rural and remote parts of the country such as northwestern Ontario. Objectives: The purpose of this study was to explore physicians’ experiences in Northwestern Ontario with MAiD. The geographic location of this study is of particular significance as physicians in rural and remote parts of Canada face unique challenges in the provision of high-quality palliative and end-of-life services. This qualitative research focused on developing a better understanding of physicians’ perceptions and practices with MAiD, in particular regarding access, decision-making, provision of service and role clarity. Methods: The researchers employed an exploratory qualitative research approach, using 1 semi-structured focus group and 18 semi-structured interviews comprising 9 set of questions. Data were collected through audio-taped semi-structured interviews, in person and by telephone. Findings: Four distinct but interconnected themes emerged from thematic analysis of the transcripts of the focus group and interviews: physician perception of patient awareness, appreciation and understanding of MAiD; challenges providing true choice at end of life; burgeoning relationships between palliative care and MAiD; and physician recommendations. Conclusion: The results of this study provide a snapshot of the Northwestern physician experiences with MAiD and contribute to the growing body of work exploring these issues on a national scale. MAiD is highlighted as both a rewarding and challenging experience for physicians in Northwestern Ontario in this study.

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A Canadian Academic Hospital’s Initial MAID Experience: A Health-Care Systems Review

Cited by 26 publications

References 4 publications

Medical Assistance in Dying (MAiD): A Descriptive Study From a Canadian Tertiary Care Hospital

Medical Assistance in Dying (MAiD): A Descriptive Study From a Canadian Tertiary Care Hospital

Voluntary assisted dying in Victoria: Why knowing the law matters to nurses

Physician snapshot: the forming landscape of MAiD in northwestern Ontario

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