Medical Assistance in Dying: A Point of Care Educational Framework For Attending Physicians

Gewarges, Mena; Gencher, Jason; Rodin, Gary; Abdullah, Nadine

doi:10.1080/10401334.2019.1682588

Cited by 10 publications

(5 citation statements)

References 13 publications

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“…Current educational frameworks focus on discussing assisted dying requests and assessing eligibility. 39 By incorporating our findings and insights from other qualitative studies on the subjective experience of assisted death and its aftermath 7,9 we can enhance training initiatives and bridge the existing educational gaps in delivering assisted dying, ultimately increasing competency in delivering assisted dying that encompasses a comprehensive consideration of the needs of all stakeholders, including family caregivers.…”

Section: Discussionmentioning

confidence: 97%

“Walk me through the final day”: A thematic analysis study on the family caregiver experience of the Medical Assistance in Dying procedure day

Nissim,

Chu,

Stere

et al. 2024

Palliat Med

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Background: Legalization of assisted dying is progressively expanding worldwide. In Canada, the Medical Assistance in Dying Act became law in 2016. As assisted dying regulations evolve worldwide, comprehending its subjective impact and broader consequences, especially on family members, becomes pivotal for shaping practice, policy, and training. Aim: The goal of this study is to understand the experience of family caregivers on the assisted dying procedure day. Design: Qualitative, thematic analysis, research using semi-structured interviews. Setting/participants: Family caregivers of patients who received assisted dying in two hospitals in Canada were recruited. Interviews were conducted at least 6 months after patient death. Conceptual saturation was achieved after analyzing 18 interviews. Results: While caregivers expressed gratitude for the availability of Medical Assistance in Dying, they also described the procedure day as potentially jarring and unsettling. We identified five aspects that shaped their experience: attuned support from the clinical team; preparation for clinical details; congruence between the setting and the importance of the event; active participation and ceremony; and pacing and timing of the procedure. Together, these aspects impacted the level of uneasiness felt by caregivers on the procedure day. Conclusions: This study emphasized the importance of a family-centered approach to delivering Medical Assistance in Dying. It underscored recognizing the needs of family caregivers during the procedure day and offering strategies to ease their experience. Healthcare providers in jurisdictions where assisted dying is legal or deliberated should consider the applicability of these findings to their unique context.

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Section: Discussionmentioning

confidence: 97%

“Walk me through the final day”: A thematic analysis study on the family caregiver experience of the Medical Assistance in Dying procedure day

Nissim,

Chu,

Stere

et al. 2024

Palliat Med

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“…To address these educational challenges, experts in Canada are working on MAiD-specific trainings. 21 For instance, two CME events involving patients-partners were also recently held in the province of Quebec. The psychiatric association of that province have organized in April 2021 a virtual half-day conference entitled MAiD in Medicine and Surgery Settings: Which Role for the Psychiatrist , since some of them are involved as a consultant in complex cases.…”

Section: Patients-partners' Contribution To Educational Challengesmentioning

confidence: 99%

Improving Palliative Care and Medical Assistance in Dying Practice in Canada: How Patients-Partners Could Contribute to Continuing Medical Education

Rivest

Rouly²,

Brouillette

et al. 2023

Palliative Medicine Reports

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Medical Assistance in Dying (MAiD) is still considered an evolving practice in Canada. Practitioners are facing the challenge of staying up to date and hence need efficient continuing medical education (CME). A patient-partner has been recently invited as a keynote speaker to CME activities in Canada to share her perspectives and views about patient engagement in palliative care and MAiD practice, calling for compassion. To our knowledge, few data exist on patient-partners' contribution to CME on these topics. Based on that experience, we discuss different issues on patient engagement's contribution in such CME events and call for further research.

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“…To our knowledge, very few training programs designed for assessors specifically addressing these psychiatric issues have been described (1,18,19), and recent data published in 2021 indicates that providers still expressed the desire for more guidance and training (20). Bator et al (2017) for example had reported that Canadian medical students' need for training on communication skills, medicolegal and religious aspects of MAiD are frequent and mostly unmet (21).…”

Section: Introductionmentioning

confidence: 99%

“…Another study from Australia has described a model for training new assessors in their jurisdiction where assisted death has been recently made accessible (22). A framework to enhance training in end-of-life care and MAiD practice in Canada has also been published, although more data is needed to know if it is feasible, efficacious, and generalizable (19). Data on the level of interest for further training and preferred format on these specific competencies of MAiD practice among requesters in Canada is still lacking and would be especially important to have as MAiD accessibility is expected to be expanded in 2023, as per Bill C-7, to patients with only mental illness as a medical condition.…”

Section: Introductionmentioning

confidence: 99%

Learning about psychiatric aspects of medical assistance in dying: a pilot survey of self-perceived educational needs among assessors in a Canadian academic hospital

Rivest¹,

Chammas²,

Jodoin³

et al. 2022

Ann Palliat Med

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Background: Medical assistance in dying (MAiD) was legalized in Canada in 2016, although it has been accessible as an end-of-life option in the province of Quebec since 2015. Before its implementation in clinical settings, few physicians had received formal training on requests assessments. New data indicate MAiD requesters have high rates of psychiatric comorbidities. Hence, assessment and management of psychiatric and psychosocial issues among MAiD requesters are important competencies to develop for assessors, although few training programs address them. The aim of our study was to explore physicians' self-perceived educational needs on psychiatric aspects related to MAiD in the province of Quebec.Methods: We conducted a cross-sectional online survey and used a non-probability sampling design in one academic tertiary care center. A descriptive analysis was performed, and responders were compared on different variables.Results: From twenty-five physician assessors, nineteen responded anonymously to an online survey (n=19).The findings of our pilot study revealed that participants felt highly competent in most psychiatric aspects at end-of-life and related to MAiD practice, except for psychotherapy and psychopharmacology as well as depression identification. Most indicated strong interest in further training. No statistical differences were found among responders regarding previous experience or training in palliative care.Conclusions: Based on our study, MAiD assessors reported high level of competency in managing psychiatric issues among requesters, but that they also expressed a strong desire for additional education.

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Medical Assistance in Dying: A Point of Care Educational Framework For Attending Physicians

Cited by 10 publications

References 13 publications

“Walk me through the final day”: A thematic analysis study on the family caregiver experience of the Medical Assistance in Dying procedure day

“Walk me through the final day”: A thematic analysis study on the family caregiver experience of the Medical Assistance in Dying procedure day

Improving Palliative Care and Medical Assistance in Dying Practice in Canada: How Patients-Partners Could Contribute to Continuing Medical Education

Learning about psychiatric aspects of medical assistance in dying: a pilot survey of self-perceived educational needs among assessors in a Canadian academic hospital

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