Health Care Provider Experiences of and Perspectives on Medical Assistance in Dying: A Scoping Review of Qualitative Studies

Brooks, Laura

doi:10.1017/s0714980818000600

Cited by 40 publications

(60 citation statements)

References 33 publications

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“…10 Other challenges included the emotional tensions experienced by palliative care physicians in the Netherlands and United States, including feelings of strain, loneliness, and being conflicted. 11 Similarly, Brooks 12 conducted a scoping review of qualitative literature and called for further investigation into the experiences of diverse MAiD providers in the Canadian setting. Reported findings specific to Dutch physician providers include studies that underline stressful, negative experiences of providing assisted dying.…”

Section: Literature Reviewmentioning

confidence: 99%

Rediscovering the art of medicine, rewards, and risks: Physicians’ experience of providing medical assistance in dying in Canada

Beuthin

Bruce

Hopwood³

et al. 2020

SAGE Open Medicine

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Background: Medical assistance in dying opens up uncharted professional territory for Canadian physicians extending their practices to include assisting and hastening death for eligible patients. Objectives: To understand physicians’ experience of participating in assisted dying and the emotional and professional impact. Methods: An interpretive descriptive methodology and thematic analysis were used for this research. We interviewed eight physicians engaged in assessing and providing medical assistance in dying. Data were collected through audio taped, semi-structured interviews in person or by phone. Results: Three overarching themes included (1) rediscovering the art of medicine, (2) unexpected rewards, and (3) negotiating risks and challenges. Each theme has accompanying sub-themes. Conclusion: Medical assistance in dying is markedly different from other physicians’ practices in that it has an enriched capacity for caring. The process brings deep satisfaction characterized by intimate, personalized contact with patients and families. The professional rewards of providing medical assistance in dying outweigh the challenges, offering an alternative narrative to more publicly accepted views of assisting someone to die.

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Section: Literature Reviewmentioning

confidence: 99%

Rediscovering the art of medicine, rewards, and risks: Physicians’ experience of providing medical assistance in dying in Canada

Beuthin

Bruce

Hopwood³

et al. 2020

SAGE Open Medicine

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“…2 However, many have identified that the experiences of family members and HCPs of people who have been found eligible for, or have received, assisted dying need to be better understood and addressed in institutional policies and care plans. 1,3 –6…”

Section: Experiences Of Family Members and Healthcare Providersmentioning

confidence: 99%

“…8 Similarly, HCPs’ involvement in the assisted dying process is often described to be psychologically and emotionally challenging. 3,5,8,9 Prescribing or administering medications that result in death typically fall under physicians’ scope of practice, with the exception of Canada, where nurse practitioners have the same privileges. 3 Other HCPs, including nurses, pharmacists/pharmacy technicians, social workers, and spiritual care practitioners, play vital roles in the assisted dying process.…”

Section: Experiences Of Family Members and Healthcare Providersmentioning

confidence: 99%

“…3,5,8,9 Prescribing or administering medications that result in death typically fall under physicians’ scope of practice, with the exception of Canada, where nurse practitioners have the same privileges. 3 Other HCPs, including nurses, pharmacists/pharmacy technicians, social workers, and spiritual care practitioners, play vital roles in the assisted dying process. 3,5,6 In Canada, healthcare ethicists have been instrumental in developing institutional policies and overseeing the delivery of assisted dying within some organizations.…”

Section: Experiences Of Family Members and Healthcare Providersmentioning

confidence: 99%

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Relational influences on experiences with assisted dying: A scoping review

et al. 2020

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Background: Family members and healthcare providers play an integral role in a person’s assisted dying journey. Their own needs during the assisted dying journey are often, however, unrecognized and underrepresented in policies and guidelines. Circumstances under which people choose assisted dying, and relational contexts such as the sociopolitical environment, may influence the experiences of family members and healthcare providers. Ethical considerations: Ethics approval was not required to conduct this review. Aim: This scoping review aims to identify the relational influences on the experiences of family members and healthcare providers of adults who underwent assisted dying and of those unable to access assisted dying due to the loss of capacity to consent. Methods: A literature search was conducted in four databases, including MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO. The search retrieved 12,074 articles, a number narrowed down to 172 articles for full-text screening. Thirty-six articles met the established inclusion criteria. A feminist relational framework guided the data analysis. Results: Five key themes on the influences of family members’ and healthcare providers’ experiences throughout the assisted dying process were synthesized from the data. They include (1) relationships as central to beginning the process, (2) social and political influences on decision making, (3) complex roles and responsibilities of family members and healthcare providers, (4) a unique experience of death, and (5) varying experiences following death. Conclusion: The feminist relational lens, used to guide analysis, shed light on the effect of the sociopolitical influences and the relationships among patients, families, and healthcare providers on each other’s experiences. Addressing the needs of the family members and healthcare providers is vital to improving the assisted dying process. Including families’ and healthcare providers’ needs within institutional policies and enhancing collaboration and communication among those involved could improve the overall experience.

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“…Regarding relationship(s) between MAiD and palliative care, participants generally reinforced the need for relationships and communication in their provision as well as the importance of interprofessional roles and dynamics for patient-centred care at end of life. 33 Participants’ eagerness to see MAiD as a component of palliative care also echoed the need for an Action Plan in order to co-exist in this new landscape, 34 especially in view of the predicament for palliative patients to have to cease medications to remain compos mentis in order to meet current MAiD criteria.…”

Section: Discussionmentioning

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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Health Care Provider Experiences of and Perspectives on Medical Assistance in Dying: A Scoping Review of Qualitative Studies

Cited by 40 publications

References 33 publications

Rediscovering the art of medicine, rewards, and risks: Physicians’ experience of providing medical assistance in dying in Canada

Rediscovering the art of medicine, rewards, and risks: Physicians’ experience of providing medical assistance in dying in Canada

Relational influences on experiences with assisted dying: A scoping review

Physician snapshot: the forming landscape of MAiD in northwestern Ontario

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