Rural healthcare professionals’ participation in Medical Assistance in Dying (MAiD): beyond a binary decision.
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Date
2024
Authors
Sedgwick, Monique
Brassolotto, Julia
Manduca-Barone, Alessandro
Journal Title
Journal ISSN
Volume Title
Publisher
Springer Nature
Abstract
Background Medical Assistance in Dying (MAiD) was legalized in Canada in 2016 and amended in 2021. At the time
that this study was conducted, the federal government was considering expanding the eligibility criteria to include
patients whose death was not reasonably foreseeable. The purpose of this study was to better understand rural
healthcare professionals’ experiences with assisted dying set against the backdrop of legislative expansion.
Methods A qualitative exploratory study was undertaken with general rural practice physicians, nurse practitioners,
registered nurses, ethicists, patients, and patient families in rural Southern Alberta, Canada. For this paper, data from
18 audio-recorded and transcribed semi-structured interviews with healthcare professionals were analyzed using
thematic analysis. Categories and patterns of shared meaning that linked to an overarching theme were identified.
Results Between the binary positions of full support for and conscientious objection to assisted dying, rural
healthcare professionals’ decisions to participate in MAiD was based on their moral convictions, various contextual
factors, and their participation thresholds. Factors including patient suffering; personal and professional values and
beliefs; relationships with colleagues, patients and family, and community; and changing MAiD policy and legislation
created nuances that informed their decision-making.
Conclusions The interplay of multiple factors and their degree of influence on healthcare professionals’ decision making create multiple decision points between full support for and participation in MAiD processes and complete
opposition and/or abstention. Moreover, our findings suggest evolving policy and legislation have the potential to
increase rural healthcare professionals’ uncertainty and level of discomfort in providing services. We propose that
the binary language typically used in the MAiD discourse be reframed to reflect that decision-making processes and
actions are often fluid and situational
Description
Open access article. Creative Commons Attribution 4.0 International license (CC BY 4.0) applies
Keywords
Assisted death , Medical assistance in dying , Palliative care , End-of-life , Healthcare professionals , Nurses , Physicians , Nurse practitioner , Clinical ethicist , Legislation , MAiD , Rural healthcare professionals
Citation
Sedgwick, M., Brassolotto, J., & Manduca-Barone, A. (2024). Rural healthcare professionals’ participation in Medical Assistance in Dying (MAiD): Beyond a binary decision. BMC Palliative Care, 23, Article 107. https://doi.org/10.1186/s12904-024-01440-4