“I Am Okay With It, But I Am Not Going to Do It”: The Exogenous Factors Influencing Non-Participation in Medical Assistance in Dying

Brown, Janine; Goodridge, Donna; Thorpe, Lilian; Crizzle, Alexander M.

doi:10.1177/10497323211027130

Cited by 19 publications

(28 citation statements)

References 46 publications

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“…Policy core beliefs, however, can also affect how VAD is implemented and operationalised. One exogenous factor that acts as a barrier to VAD implementation is concern about a lack of available palliative care and other end-of-life care resources (Brown et al, 2021a;Haining et al, 2021). In this study, this was reflected in the policy core belief Government, including law and policy, has a However, while an individual health professional cannot be compelled to participate in VAD, the extent to which a health service or institution can refuse to participate is less well-defined (White et al, 2021).…”

Section: Results Summarymentioning

confidence: 99%

“…Policy core beliefs, however, can also affect how VAD is implemented and operationalised. One exogenous factor that acts as a barrier to VAD implementation is concern about a lack of available palliative care and other end‐of‐life care resources (Brown et al, 2021a ; Haining et al, 2021 ). In this study, this was reflected in the policy core belief Government, including law and policy, has a legitimate role in VAD .…”

Section: Discussionmentioning

confidence: 99%

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Implementing voluntary assisted dying laws in healthcare: Exploring beliefs to identify implementation hurdles

Hewitt

Lawson

Verrall

et al. 2022

Research in Nursing & Health

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The number of countries introducing voluntary assisted dying (VAD) laws is increasing. Actively taking steps to end a person's life is contentious so implementing these laws into healthcare services presents unique challenges. Theoretically underpinned by the Advocacy Coalition Framework, this study identified the beliefs of classes of stakeholders who engaged with the parliamentary process associated with the introduction of VAD laws in Queensland, Australia. Submissions about VAD made to a parliamentary inquiry were allocated to a class and qualitatively analysed to identify underlying beliefs. The data were then subjected to statistical analysis including nonmetric dimensional scaling and one-way analysis of similarity. Data visualisation techniques were used to generate a chord map and heatmap, to identify the belief types, as well as similarities and differences between beliefs and among classes. Fourteen different beliefs were identified in the 91 reviewed submissions.Six were deep core beliefs and eight were policy core beliefs. Beliefs could be associated with a positive or negative sentiment toward VAD. In this study, the class of Health Services expressed more negative sentiments to VAD than neutral or positive sentiments. The sentiments expressed by the class of Health Professionals were equally divided between positive, neutral and negative. These findings provide important insights for implementors as laws become operational. In particular, for organisations that provide health services, clear articulation of their stance in relevant policy and guidance documents is recommended.

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Section: Results Summarymentioning

confidence: 99%

“…Policy core beliefs, however, can also affect how VAD is implemented and operationalised. One exogenous factor that acts as a barrier to VAD implementation is concern about a lack of available palliative care and other end‐of‐life care resources (Brown et al, 2021a ; Haining et al, 2021 ). In this study, this was reflected in the policy core belief Government, including law and policy, has a legitimate role in VAD .…”

Section: Discussionmentioning

confidence: 99%

Implementing voluntary assisted dying laws in healthcare: Exploring beliefs to identify implementation hurdles

Hewitt

Lawson

Verrall

et al. 2022

Research in Nursing & Health

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“…Indeed, following more than 20 years of failure of French policies promoting palliative care,17 legalising MAID could undermine the development of palliative care in already unequal territory 18. Such concern has already been reported by PCP in countries where MAID is legal,19 20 and arguments, such as the large increase in MAID in European countries where it is legal, support this idea 21 22. However, counterexamples exist,21 23 such as in Oregon where palliative care has grown alongside a rather stable rate of medically assisted deaths 21.…”

Section: Discussionmentioning

confidence: 99%

Legalised active assistance in dying: palliative care stakeholders’ national e-consultation

Economos

Moulin

Perceau-Chambard

et al. 2023

BMJ Support Palliat Care

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ObjectivesThere is a growing debate surrounding the legalisation of medical assistance in dying (MAID). MAID is currently prohibited by the French law; however, the debate has recently been reinvigorated in France. This study aims to collect opinions of palliative care stakeholders (PCS) regarding the legalisation of MAID and to identify the factors associated with their opinions.MethodsWe performed a transversal survey between 26 June 2021 and 25 July 2021, on PCS who were on the French national scientific society for palliative care. Participants were invited by email.Results1439 PCS took part and expressed an opinion about the legalisation of MAID. 1053 (69.7%) were against the legalisation of MAID. When forced to choose which option should be privileged if the law had to change, 3.7% favoured euthanasia, 10.1% favoured assisted suicide with provision of lethal drug by a professional, 27.5% favoured assisted suicide with prescription of a lethal drug and 29.5% favoured assisted suicide with provision of a lethal drug by an association. The opinion regarding legalisation of MAID was statistically different depending on the participant profession (p<0.001) and when comparing clinical and non-clinical positions (p<0.001). A quarter of participants (26.7%) believe that legalising MAID might lead them to change their current position.ConclusionsOverall, French palliative care professionals are against a modification of the current legal framework for legalising MAID but some might change their current position if a law was voted. This might destabilise the PCS demography that is already worrying.

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“…A few studies examined factors influencing provider nonparticipation. [11][12][13] These factors include faith or spirituality, emotional burden, practice context, time, and the risks associated with participating in MAiD. In contrast, other studies looked at the reasons for providers wanting to participate in MAiD.…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to engaging in the practice of medical assistance in dying among providers in Canada: a scoping review protocol

Légère

Doucet

Luke

et al. 2023

JBI Evidence Synthesis

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Introduction:The number of MAiD requests in Canada is growing steadily and is predicted to continue to grow with the passing of Bill C-7 in 2021, which expands access to individuals whose deaths are not reasonably foreseeable. Under federal law, physicians and nurse practitioners are the only health care professionals permitted to assess for and administer MAiD. Providers are not obligated to engage in the practice of MAiD; therefore, patient access relies on providers' readiness to engage in the practice. More information is needed to understand the barriers and facilitators for engaging in MAiD care from the perspective of providers.Inclusion criteria: This review will consider studies that identify physicians, nurse practitioners, and medical residents' perceived barriers and facilitators for engaging in the practice of MAiD in Canada. Physicians, nurse practitioners, and medical residents who do not directly administer MAiD, including those who identify as conscientious objectors or non-participants, will be included. Studies looking at barriers and facilitators for providing MAiD care to individuals with dementia, mental illness, or for individuals under the age of 18 years will be excluded.Methods: MEDLINE, Embase, CINAHL with Full-text, and APA PsycINFO will be searched. Studies will be screened and data extracted by 2 independent reviewers using a tool created for this review. The scoping review findings will be presented in a narrative format and mapped in tables to address the review aims.

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“I Am Okay With It, But I Am Not Going to Do It”: The Exogenous Factors Influencing Non-Participation in Medical Assistance in Dying

Cited by 19 publications

References 46 publications

Implementing voluntary assisted dying laws in healthcare: Exploring beliefs to identify implementation hurdles

Implementing voluntary assisted dying laws in healthcare: Exploring beliefs to identify implementation hurdles

Legalised active assistance in dying: palliative care stakeholders’ national e-consultation

Barriers and facilitators to engaging in the practice of medical assistance in dying among providers in Canada: a scoping review protocol

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