Physician-Assisted Death Psychiatric Assessment: A Standardized Protocol to Conform to the California End of Life Option Act

Bourgeois, James A.; Mariano, Maria Theresa; Wilkins, James M.; Brendel, Rebecca W.; Kaplan, Lawrence; Ganzini, Linda

doi:10.1016/j.psym.2018.02.003

Cited by 18 publications

(9 citation statements)

References 13 publications

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“…Differentiating suicidal ideation as a depressive symptom from a desire to hasten death with a MAiD request, can be in some cases a learning opportunity for which providers might ask for an independent opinion of a psychiatrist. Consultation-liaison psychiatrits have been in fact involved in complexes cases of physician-assisted death around the world and might offer assistance in clarifying capacity, identifying mental disorders or helping along with the rest of the team to resolve complex relational issues or manage suicidality (17,38,39).…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…To protect vulnerable dying persons, guidelines and safeguards exist and standards have been developed for psychiatric assessment which include assessment of decisional capacity, psychiatric status over the previous 30 days, formal rating scales, narrative regarding seeking of physician-assisted dying, diagnostic formulation, and documentation of the elements of decision capacity rubric (Understanding/ Appreciation /Rationality/Communication of Choice) [76]. To summarize, physician-assisted dying is increasingly being legalized, remains relatively rare, and primarily involves persons dying of cancer.…”

Section: Medical-assisted Dyingmentioning

confidence: 99%

Palliative and End-of-Life Care in HIV

Lyon¹,

Carmen²,

Makurumidze³

et al. 2021

HIV Psychiatry

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“…For this chapter, we have synthesized several efforts to articulate what a sound capacity evaluation might look like in this situation. These include an early set of standards crafted by Werth and colleagues (2000), guidelines constructed by the California Psychological Association (California Psychological Association End of Life Option Act Work Group, 2017), and the Washington State Psychological Association (2009) to help professionals in those states, a recent brief published by the American Academy of Hospice and Palliative Medicine (n.d.), and a standardized protocol developed by the Department of Psychiatry at the University of California, San Francisco Medical Center (Bourgeois et al, 2018). The issue continues to evolve, however, and readers should understand that this chapter will likely need updating as public policy and professional opinion moves forward.…”

Section: Steps In the Capacity Assessmentmentioning

confidence: 99%

Assessment of capacity in medical aid in dying.

Carpenter¹,

Merz²

2020

Assessing Capacities of Older Adults: A Casebook to Guide Difficult Decisions.

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Capacity evaluations for medical aid in dying are required only if a physician who has received a request for a lethal prescription suspects a patient's judgment may be impaired. • Although no empirically based instruments or protocols are available to evaluate capacity in the context of medical aid in dying, clinicians can reasonably adapt instruments used in other capacity contexts and can rely on guidelines constructed recently by state psychological associations and hospitals.• The ultimate question for the mental health professional is: Does the patient have the capacity to request a prescription to take by themselves to end their life?• As in other contexts, capacity is based on four standards the patient must demonstrate: understanding, appreciation, reasoning, and the ability to communicate a choice.• Data for evaluating capacity can come from multiple sources, including the patient, care partners, medical providers, medical records, and previous expressions of the patient's values and preferences (e.g., advance directives).

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Physician-Assisted Death Psychiatric Assessment: A Standardized Protocol to Conform to the California End of Life Option Act

Cited by 18 publications

References 13 publications

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

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

Palliative and End-of-Life Care in HIV

Assessment of capacity in medical aid in dying.

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