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- Title
Practitioners' experiences with 2021 amendments to Canada's medical assistance in dying law: a qualitative analysis.
- Authors
Close, Eliana; Downie, Jocelyn; White, Ben P.
- Abstract
Background: In 2016, Canada joined the growing number of jurisdictions to legalize medical assistance in dying (MAiD), when the Supreme Court of Canada's decision in Carter v Canada took effect and the Canadian Parliament passed Bill C-14. Five years later, Bill C-7 introduced several significant amendments. These included removing the 'reasonably foreseeable natural death' requirement (an aspect that was widely debated) and introducing the final consent waiver. Since Bill C-7 is so new, very little research has investigated its operation in practice. Objectives: This study investigates the experiences of MAiD assessors and providers regarding the Bill C-7 amendments. It explores implications for understanding and improving regulatory reform and implementation. Design: Qualitative thematic analysis of semi-structured interviews. Methods: In all, 32 MAiD assessors and providers (25 physicians and 7 nurse practitioners) from British Columbia (n = 10), Ontario (n = 15) and Nova Scotia (n = 7) were interviewed. Results: The analysis resulted in five themes: (1) removing barriers to MAiD access; (2) navigating regulatory and systems recalibration; (3) recognizing workload burdens; (4) determining individual ethical boundaries of practice and (5) grappling with ethical tensions arising from broader health system challenges. Conclusion: This is one of the first studies to investigate physicians' and nurse practitioners' experiences of the impact of Bill C-7 after the legislation was passed. Bill C-7 addressed key problems under Bill C-14, including the two witnesses requirement and the 10-day waiting period. However, it also introduced new complexities as practitioners decided how to approach cases involving a non-reasonably foreseeable natural death (and contemplated the advent of MAiD for persons with a mental disorder as a sole underlying condition). This study highlights the importance of involving practitioners in advance of legislative changes. It also emphasizes how the regulation of MAiD involves a range of organizations, which requires strong leadership and coordination from the government.
- Subjects
CANADA; ASSISTED suicide laws; EUTHANASIA laws; ATTITUDES of medical personnel; WORK; RESEARCH methodology; ASSISTED suicide; INTERVIEWING; RIGHT to die; POPULATION geography; QUALITATIVE research; HUMAN services programs; EXPERIENTIAL learning; EUTHANASIA; SOUND recordings; DESCRIPTIVE statistics; RESEARCH funding; PHYSICIANS; DATA analysis software; THEMATIC analysis
- Publication
Palliative Care & Social Practice, 2023, p1
- ISSN
2632-3524
- Publication type
Article
- DOI
10.1177/26323524231218282