Wanstead House

Armstrong, Hannah

doi:10.2307/j.ctv2crj1w9

Cited by 1 publication

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“…In the US, medical aid in dying (MAID) allows patients with a terminal illness and a life expectancy of less than 6 months to request a prescription for oral medication that will end their life upon self-administration . On April 8, 2021, New Mexico Governor Michelle Lujan Grisham signed the Elizabeth Whitefield End-of-Life Options Act, making it the 10th US state and 11th US jurisdiction to permit MAID . This law is the first in the US to allow physician assistants (PAs) and nurses licensed in advanced practice (herein NPs, acknowledging that titles, credentials, and actual roles for advanced nursing professionals vary by state but typically include nurse practitioners, nurse anesthetists, clinical nurse specialists, and nurse midwives) to prescribe and consult on MAID cases.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Oncology Advanced Practice Professional Willingness to Participate in Medical Aid in Dying

et al. 2022

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ImportanceIn 2021, New Mexico passed legislation allowing nurse practitioners and physician assistants (referred to herein as advanced practice professionals [APPs]) to prescribe medications for medical aid in dying (MAID). Other US states with existing MAID laws (eg, Washington) are also considering expanding MAID prescribing authority to APPs. There is a lack of research exploring APP knowledge of, willingness to, and comfort with acting as a prescribing or consulting clinician for MAID.ObjectiveTo assess perspectives of oncology APPs regarding MAID, including their willingness to prescribe and/or consult for MAID and factors associated with willingness.Design, Setting, and ParticipantsThis cross-sectional, self-report survey study used data collected from APPs working at a comprehensive cancer center in Washington State in fall 2021.Main Outcomes and MeasuresThe primary survey question was whether APPs would be willing to participate in death with dignity, the term used for MAID in Washington. Survey questions evaluated how influential specific factors were on APP views on MAID as well as respondents’ knowledge of and comfort with aspects of the MAID process.ResultsOf 167 eligible APPs, 77 (46.1%) responded to the survey. Most respondents (68 [88.3%]) reported their race and ethnicity as White; 72 (93.5%) identified as a woman. Medical oncology (28 [36.4%]) was the most common field of practice, and 21 respondents (27.3%) reported having practiced as an APP for 6 to 10 years. Of all respondents, 61 (79.2%) reported having at least 1 patient who inquired about MAID; depending on the question, less than a third of respondents (5.0%-27.0%) endorsed feeling knowledgeable or very knowledgeable about any aspect of the MAID process. In this study, 39 APPs (50.6%) endorsed being willing to participate in MAID either as a consulting or prescribing clinician, whereas 31 (40.3%) were uncertain of whether they would participate. Willingness to participate was associated with having had more patients pursue MAID (33 of the 39 willing participants [84.6%] vs 15 of the 31 unsure participants [48.4%] reported having 1 or more patients pursue MAID). Higher knowledge and comfort scores were both significantly associated with increased odds of being willing to participate (odds ratio, 1.14 per 1-point score increase [95% CI, 1.03-1.27]; P = .01) vs unsure (1.18 [95% CI, 1.07-1.30; P = .001).Conclusions and RelevanceThe results of this survey study suggest that oncology APPs may require preparation for the addition of MAID to their scope of practice. This study also raises questions for future research regarding support for APPs who may be considering participation in MAID but question their role or want physician involvement.

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Section: Introductionmentioning

confidence: 99%