From Prohibition to Permission: The Winding Road of Medical Assistance in Dying in Canada

Downie, Jocelyn

doi:10.1007/s10730-022-09488-6

Cited by 9 publications

(10 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As noted in the Method section, Canada’s MAiD law is set at the highest level through the Criminal Code , which is under the jurisdiction of the federal Parliament. 9 Implementation is then regulated through court cases and is regulated and systematized at the provincial/territorial, regional and local levels through provincial/territorial governments, regulatory bodies, MAiD programs, healthcare institutions and communities of practice. This theme reflects participants’ integration of Bill C-7 into practice, as well as consequential alterations to other regulations and system guidance.…”

Section: Resultsmentioning

confidence: 99%

“…Bill C-7 also introduced amendments prompted by advocacy efforts and evidence about barriers in practice under Bill C-14. 9 These changes included removing the 10-day waiting period for Track 1 patients, streamlining witnessing requirements for the written request and permitting two types of advance requests for MAiD in limited circumstances (a ‘final consent waiver’ and ‘advance consent for failed self-administration’). Finally, Bill C-7 temporarily excluded access to MAiD for persons with mental disorder as their sole underlying medical condition (MAiD MD-SUMC).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Practitioners’ experiences with 2021 amendments to Canada’s medical assistance in dying law: a qualitative analysis

Close,

Downie,

White

2023

Palliat�Care

Self Cite

View full text Add to dashboard Cite

Background: In 2016, Canada joined the growing number of jurisdictions to legalize medical assistance in dying (MAiD), when the Supreme Court of Canada’s decision in Carter v Canada took effect and the Canadian Parliament passed Bill C-14. Five years later, Bill C-7 introduced several significant amendments. These included removing the ‘reasonably foreseeable natural death’ requirement (an aspect that was widely debated) and introducing the final consent waiver. Since Bill C-7 is so new, very little research has investigated its operation in practice. Objectives: This study investigates the experiences of MAiD assessors and providers regarding the Bill C-7 amendments. It explores implications for understanding and improving regulatory reform and implementation. Design: Qualitative thematic analysis of semi-structured interviews. Methods: In all, 32 MAiD assessors and providers (25 physicians and 7 nurse practitioners) from British Columbia ( n = 10), Ontario ( n = 15) and Nova Scotia ( n = 7) were interviewed. Results: The analysis resulted in five themes: (1) removing barriers to MAiD access; (2) navigating regulatory and systems recalibration; (3) recognizing workload burdens; (4) determining individual ethical boundaries of practice and (5) grappling with ethical tensions arising from broader health system challenges. Conclusion: This is one of the first studies to investigate physicians’ and nurse practitioners’ experiences of the impact of Bill C-7 after the legislation was passed. Bill C-7 addressed key problems under Bill C-14, including the two witnesses requirement and the 10-day waiting period. However, it also introduced new complexities as practitioners decided how to approach cases involving a non-reasonably foreseeable natural death (and contemplated the advent of MAiD for persons with a mental disorder as a sole underlying condition). This study highlights the importance of involving practitioners in advance of legislative changes. It also emphasizes how the regulation of MAiD involves a range of organizations, which requires strong leadership and coordination from the government.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Practitioners’ experiences with 2021 amendments to Canada’s medical assistance in dying law: a qualitative analysis

Close,

Downie,

White

2023

Palliat�Care

Self Cite

View full text Add to dashboard Cite

show abstract

“…This recognized that the removal of death must be in the foreseeable future, as well as narrowing eligibility so that the person must suffer from a serious and incurable illness, disease, or disability. Canadians reported that they felt the process and criteria seemed relatively easy and uncontroversial (Downie, 2022). Notably, the most controversial element of this bill was the black-and-white definition created for a grievous and irremediable medical condition.…”

Section: Implications For Health Social Work Professions and Familiesmentioning

confidence: 99%

“…Notably, the most controversial element of this bill was the black-and-white definition created for a grievous and irremediable medical condition. Due to these changes, some individuals are no longer eligible under new federal legislation, causing constitutional law scholars to testify before the House and Senate committees reviewing the bill (Downie, 2022).…”

Section: Implications For Health Social Work Professions and Familiesmentioning

confidence: 99%

A Critical Review: Medical Assistance in Dying Policy in Canada

Dhungel

2023

MAS

View full text Add to dashboard Cite

Medical Assistance in Dying (MAiD) has become more assessable in Canada for those with and without long term chronic illness. The changes in legislation have brought significant concerns to Canadians and healthcare professionals. This Paper critically examines the current and past legislation from an anti- oppressive theoretical lens. Since the Canadian government has significantly changed the legislation since, MAiD (Medical Assistance in Dying) Bill C-7 was passed in 2016. This paper begins with a discussion of a brief introduction followed by a theoretical framework, anti-oppressive practice. Eligibility and accessing process for MAiD will be explored in this article. This paper concludes with the presentation of the implications in social work profession and health care and provide some recommendations.

show abstract

“…• How have ethicists and ethics services participated in the introduction of MAiD in Canada over the first 6 years-both in the legal process that led to the current MAiD legislation (Downie 2022), and in addressing it as a novel organizational ethics challenge (Frolic & Miller, 2022;Bouthillier et al 2022)?…”

Section: Beyond the Norm(ative): Exploring The Practical Ethics Of Ma...mentioning

confidence: 99%

Introducing Medical Assistance in Dying in Canada: Lessons on Pragmatic Ethics and the Implementation of a Morally Contested Practice

Frolic

Oliphant

2022

HEC Forum

View full text Add to dashboard Cite

Medical Assistance in Dying (MAiD) in Canada has had a tumultuous social and legal history. In the 6 years since assisted dying was decriminalized by the Canadian Parliament in June 2016, the introduction of this practice into the Canadian healthcare system has been fraught with ethical challenges, practical hurdles and grassroots innovation. In 2021, MAiD accounted for approximately 3.3% of all Canadian deaths annually, and more patients are seeking MAiD year over year as this option becomes more widely know. Unfortunately, some patients who want MAiD are unable to access it in a timely manner because of a lack of willing MAiD providers. This introduction describes statistics about the uptake of MAiD in Canada and the challenges presented by Canadians' rapid acceptance of this end of life care option. In this special edition of HEC Forum about the implementation of MAiD in Canada, authors depict a range of ethical challenges and strategies to address issues related to MAiD access and quality, organizational engagement, clinician recruitment and retention, and support for a morally diverse workforce. In each article, the authors reflect on the question: What are the practical ethics involved in introducing assisted dying into a new healthcare context, and how can ethicists and ethics resources collaborate with stakeholders to ensure the integration of ethical considerations as this practice continues to evolve?

show abstract

From Prohibition to Permission: The Winding Road of Medical Assistance in Dying in Canada

Cited by 9 publications

References 9 publications

Practitioners’ experiences with 2021 amendments to Canada’s medical assistance in dying law: a qualitative analysis

Practitioners’ experiences with 2021 amendments to Canada’s medical assistance in dying law: a qualitative analysis

A Critical Review: Medical Assistance in Dying Policy in Canada

Introducing Medical Assistance in Dying in Canada: Lessons on Pragmatic Ethics and the Implementation of a Morally Contested Practice

Contact Info

Product

Resources

About