CANADIAN EXPERIENCE WITH MAID

Published Research

2017

1. Bator EX, Philpott B, Costa AP. This moral coil: a cross-sectional survey of Canadian medical student attitudes toward medical assistance in dying. BMC Med Ethics. 2017 Oct 27;18(1):58,017-0218-5.

2. Li M, Rodin G. Medical Assistance in Dying. N Engl J Med. 2017 Aug 31;377(9):897-8.

3. Marrie RA, Salter A, Tyry T, Cutter GR, Cofield S, Fox RJ. High hypothetical interest in physician-assisted death in multiple sclerosis. Neurology. 2017 Apr 18;88(16):1528-34.

4. Robertson WD, Pewarchuk J, Reggler J, Green S, Daws T, Trouton K. Case Review of Medically Assisted Deaths on Vancouver Island. 2017 BC Med J

5. Rosso A, Huyer D, Walker A. Analysis of the Medical Assistance In Dying Cases In Ontario: Understanding the Patient Demographics of Case Uptake In Ontario Since the Royal Assent and Amendments of Bill C-14 in Canada. Acad Forensic Pathol. 2017 7(2): 263-287

6. Allard J, Fortin MC. Organ donation after medical assistance in dying or cessation of life-sustaining treatment requested by conscious patients: the Canadian context. J Med Ethics. 2017 Sep;43(9):601-605.

2018

1. Elie D, Marino A, Torres-Platas SG, Noohi S, Semeniuk T, Segal M, et al. End-of-Life Care Preferences in Patients with Severe and Persistent Mental Illness and Chronic Medical Conditions: A Comparative Cross-Sectional Study. Am J Geriatr Psychiatry. 2018 Jan;26(1):89-97.

2. Khoshnood N, Hopwood MC, Lokuge B, Kurahashi A, Tobin A, Isenberg S, Husain A. Exploring Canadian Physicians’ Experiences Providing Medical Assistance in Dying: A Qualitative Study. J Pain Symptom Manage. 2018 May 15.

3. Beuthin, R & Bruce, A. Medical Assistance in Dying (MAiD): Canadian Nurses’ Experiences. Nurs Forum 2018:1-10

4. Beuthin R. Cultivating Compassion: The Practice Experience of a Medical Assistance in Dying Coordinator in Canada Qualitative Health Research 2018, Vol. 28(11) 1679–1691

5. Wright, A. C. & Shaw, J. C. (2018). The spectrum of end of life care: an argument for access to medical assistance in dying for vulnerable populations. Medicine, Health Care and Philosophy, (), 1-9.

6. Shaw J, Wiebe ER, Nuhn A, Holmes S, Kelly M, Just A. Providing Medical Assistance in Dying: Practice Perspectives. Can Fam Phys 2018;64(9)e394-9.

7. Holmes S, Nuhn A, Kelly M, Shaw J, Just A, Wiebe ER. A Qualitative Study Exploring the Journey of Supporting a Loved One through a Medically-Assisted Death in Canada Can Fam Phys 2018;64(9)e387-93.

8. Nuhn A, Holmes S, Kelly M, Just A, Shaw J, Wiebe ER. Experiences and perspectives of people who pursued Medical Assistance in Dying (MAiD) in Vancouver, Canada Can Fam Phys 2018;64(9)e380-6.

9. Wiebe ER, Shaw J, Green S, Trouton K, Kelly M. Reasons for Requesting Medical Assistance in Dying (MAiD) Can Fam Phys 2018;64(9)674-9.

10. Wiebe E, Green S, Schiff B. Teaching residents about medical assistance in dying. Can Fam Physician. 2018 Apr;64(4):315-6.

11. Robertson WD, Beuthin R. A Review of Medical Assistance in Dying on Vancouver Island July 2016-July 2018 https://www.islandhealth.ca/sites/default/files/2018-10/MAiD-Report-2016-2018.pdf

12. Crumley ET, Sheppard C, Bowden C, Nelson G. Canadian French and English newspapers’ portrayals of physicians’ role and medical assistance in dying (MAiD) from 1972-2016: a qualitative textual analysis. BMJ Open. (accepted 18 Dec 2018)

13. Wales J, Isenberg SR, Wegier P, Shapiro J, Cellerius V, Husain A, Khoshnood N. Providing Medical Assistance in Dying within a Home Palliative Care Program in Toronto, Canada: An Observational Study of the First Year of Experience 2018 J Pall Med VOL. 21, NO.11 Published Online: 29 Oct 2018 https://doi.org/10.1089/jpm.2018.0175

14. MacDonald S, LeBlanc S, Dalgarno N, Schultz K, Johnston E, Martin M, Zimmerman D. Exploring family medicine preceptor and resident perceptions of medical assistance in dying and desires for education. Can Fam Physician. 2018 Sep;64(9):e400-e6. PMID: 30209114.

15. Stewart DE, Rodin G, Li M. Consultation-liaison psychiatry and physician-assisted death. Gen Hosp Psych Vol 55, November–December 2018, Pages 15-19

16. Verweel L, Rosenberg-Yunger ZRS, Movahedi T, Malek AH. Medical assistance in dying: Examining Canadian pharmacy perspectives using a mixed-methods approach. Can Pharm J (Ott). 2018;151(2):121‐132. Published 2018 Feb 9. doi:10.1177/1715163518754917

2019

1. Brown J, Thorpe L, Goodridge D. Completion of Medical Certificates of Death after an Assisted Death: An Environmental Scan of Practices. https://www.longwoods.com/content/25685/healthcare-policy/completion-of-medical-certificates-of-death-after-an-assisted-death-an-environmental-scan-of-practice

2. Antifaeff K. Social Work Practice with Medical Assistance in Dying: A Case Study. 2019 Nat Assoc Soc Workers doi:10.1093/hsw/hlz002

3. Reel K. Denying Assisted Dying Where Death is Not ‘Reasonably Foreseeable’: Intolerable Overgeneralization in Canadian End-of-Life Law. 2019 Canadian Journal of Bioethics

4. Wiebe E, Shaw J, Wright A, Kelly M. Suicide vs Medical Assistance in Dying (MAiD): a secondary qualitative analysis. Death Studies 2019 in press

5. McMechan, C., Bruce, A. & Beuthin, R. (2019). Canadian Nursing Students’ Experiences with Medical Assistance in Dying. Quality Advancement in Nursing Education (5),1 (Article 2).DOI: https://doi.org/10.17483/2368-6669.1179

6. Beuthin, R. & Bruce, A. (2019). Medical assistance in dying (MAiD): Ten Things Leaders Need to Know. Canadian Journal of Nursing Leadership, 31(4), 74-81.

7. Bruce, A., & Beuthin, R. (2019). Medically Assisted Dying in Canada: “Beautiful Death” Is Transforming Nurses’ Experiences of Suffering. Canadian Journal of Nursing Research. https://doi.org/10.1177/0844562119856234

8. Shaw, J., Harper, L., Preston, E., Wright, A., Kelly, M., & Wiebe, E. (2019). Perceptions and Experiences of Medical Assistance in Dying Among Illicit Substance Users and People Living in Poverty. OMEGA – Journal of Death and Dying. https://doi.org/10.1177/0030222819889827

9. Selby D, Bean S, Isenberg-Grzeda E. Medical Assistance in Dying (MAiD): A Descriptive Study From a Canadian Tertiary Care Hospital American Journal of Hospice and Palliative Medicine 2019 DOI:10.1177/1049909119859844

10. Dion S, Wiebe E, Kelly M. Quality of care with telemedicine for medical assistance in dying eligibility assessments: a qualitative study Can Med Assoc J Open 2019 doi: 10.9778/cmajo.20190111 cmajo December 13, 2019 vol. 7 no. 4 E721-E729

11. Harty C, Chaput AJ, Trouton K, Buna C, Naik VN. Oral medical assistance in dying (MAiD): informing practiceto enhance utilization in CanadaL’aide me´dicale a`mourir administre´e par voie orale : commente´clairer la pratique pour en ame´liorer son utilisation au Canada Can J Anesth/J Can Anesth (2019) 66:1106–1112 https://doi.org/10.1007/s12630-019-01389-6

12. Schiller, C., Pesut, B., Roussel, J., & Greig, M. But it’s legal isn’t it? Law and ethics in nursing practice related to medical assistance in dying. (2019). Nursing Philosophy. Published online August 20, 2019 https://onlinelibrary.wiley.com/doi/epdf/10.1111/nup.12277.[Major] [Impact Factor 1.07]

13. Pesut, B., Thorne, S., & Greig, M. Shades of grey: Conscientious objection in medical assistance in dying. (2019) Nursing Inquiry Published online July 4, 2019. doi.org/10.1111/nin.12308.

14. Pesut, B., Thorne, S., Greig, M., Fulton, A., Janke, R., & Vis-Dunbar, M. (2019) Ethical, policy, and practice implications of nurses’ experiences with assisted death: A synthesis. Advances in Nursing Science, 42(3) 216-230. doi: 10.1097/ANS.0000000000000276.

15. Pesut, B., Thorne, S., Stager, M.L., Schiller, C., Penney, C., Hoffman, C., Greig, M., & Roussel, J. (2019) Medical assistance in dying: A narrative review of Canadian nursing regulatory documents. Policy, Politics and Nursing Practice, Published online May 6, 2019. doi/10.1177/1527154419845407.

16. Pesut, B., Greig, M., Thorne, S., Storch, J. Burgess, M., Tishelman, C., Chambaere, K., Janke, R. (2019) Nursing and euthanasia: A narrative review of the nursing ethics literature. Nursing Ethics. Published online May 22, 1-16. Doi:10.1177/0969733019845127.

17. Selby D, Bean S. Oncologists communicating with patients about assisted dying. Current Opinion in Supportive & Palliative Care. 13(1):59-63, March 2019.

18. Bravo GA-O, Trottier L, Rodrigue C, Arcand M, Downie J, Dubois MF, Kaasalainen S, Hertogh CM, Pautex S, Van den Block L. Comparing the attitudes of four groups of stakeholders from Quebec, Canada, toward extending medical aid in dying to incompetent patients with dementia. Int J Geriatr Psychiatry. 2019 Jul;34(7):1078-86.PMID: 31034669.

19. Suva G, Penney T, McPherson CJ.Medical Assistance in Dying: A Scoping Review to Inform Nurses’ Practice. J Hosp Palliat Nurs. 2019 Feb;21(1):46-53. PMID: 30608357.

20. Belanger E, Towers A, Wright DK, Chen Y, Tradounsky G, Macdonald ME.Of dilemmas and tensions: a qualitative study of palliative care physicians’ positions regarding voluntary active euthanasia in Quebec, Canada. J Med Ethics. 2019 Jan;45(1):48-53.AccessionNum: 30377217.

21. Janine Brown, Donna Goodridge, Averi Harrison, Jordan Kemp, Lilian Thorpe, and Robert Weiler. Medical Assistance in Dying: Patients’, Families’, and Health Care Providers’ Perspectives on Access and Care Delivery Journal of Palliative Medicine. ahead of print http://doi.org/10.1089/jpm.2019.0509

22. Wilson DM, Triscott JAC, Cohen J, MacLeod R. Educational needs of healthcare professionals and members of the general public in Alberta Canada, 2 years after the implementation of medical assistance in dying.Health Soc Care Community. 2019 Sep;27(5):1295-302. PMID: 31149763.

23. Wong A, Hsu AT, Tanuseputro P. Assessing attitudes towards medical assisted dying in Canadian family medicine residents: a cross-sectional study. BMC Med Ethics. 2019 Dec 27;20(1):103. PMID: 31881966.

24. Bouthillier ME, Opatrny L. A qualitative study of physicians’ conscientious objections to medical aid in dying.Palliat Med. 2019 Oct;33(9):1212-20. PMID: 31280666.

25. Silvius JL, Memon A, Arain M.Medical Assistance in Dying: Alberta Approach and Policy Analysis.Can J Aging. 2019 Sep;38(3):397-406. PMID: 31046853.Link to full text: https://www.cpsbc.ca/proxyauth/?url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F31046853%3Fotool%3Dicacpbclib

26. Hales BM, Bean S, Isenberg-Grzeda E, Ford B, Selby D.Improving the Medical Assistance in Dying (MAID) process: A qualitative study of family caregiver perspectives. Palliat Support Care. 2019 Oct;17(5):590-5. PMID: 30887936.
Link to full text: https://www.cpsbc.ca/proxyauth/?url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F30887936%3Fotool%3Dicacpbclib

27. Brooks L. Health Care Provider Experiences of and Perspectives on Medical Assistance in Dying: A Scoping Review of Qualitative Studies. Can J Aging. 2019 Sep;38(3):384-96. PMID: 30626453. Link to full text: https://www.cpsbc.ca/proxyauth/?url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F30626453%3Fotool%3Dicacpbclib

28. Konder RM, Christie T. Medical Assistance in Dying (MAiD) in Canada: A Critical Analysis of the Exclusion of Vulnerable Populations.Healthc Policy. 2019 Nov;15(2):28-38. PMID: 32077843.

2020

1. Redelmeier, D.A., Detsky, A.S. Economic Theory and Medical Assistance in Dying. Appl Health Econ Health Policy (2020). https://doi.org/10.1007/s40258-020-00587-4

2. Selby DA-OhooX, Bean S, Isenberg-Grzeda E, Bioethics BHD, Nolen A.Medical Assistance in Dying (MAiD): A Descriptive Study From a Canadian Tertiary Care Hospital. Am J Hosp Palliat Care. 2020 Jan;37(1):58-64.AccessionNum: 31256607.

3. Beuthin R, Bruce A, Hopwood MC,Robertson WD, Bertoni K. Rediscovering the art of medicine, rewards, and risks: Physicians’ experience of providing medical assistance in dying in Canada. 2020 SAGE Open Medicine Volume 8: 1–9 DOI: 10.1177/2050312120913452

4. Downer J, et al. Early experience with medical assistance in dying in Ontario, Canada: A cohort study,’ Canadian Medical Association Journal, published online 11 February 2020.

5. Praslickova Z, Kelly M, Wiebe E. (2020) The experience of volunteer witnesses for Medical Assistance in Dying (MAiD) requests, Death Studies, DOI: 10.1080/07481187.2020.1716884

6. Trouton K., Beuthin, R., Thompson, M., Bruce, A., Lemire-Elmore, C., Zhang, A., & Daudt, H. Attitudes and expectations regarding bereavement support for patients, family members, and friends: Findings from a survey of MAID provider. BC Med J, vol. 62 , No. 1 , January February2020 , Pages 18-23

7. Variath C, Peter E, Cranley L, Godkin D, Just D. Relational influences on experiences with assisted dying: A scoping review May 2020 Nursing Ethics DOI: 10.1177/0969733020921493

8. Isenberg-Grzeda E, Bean S, Cohen C, Selby D. Suicide Attempt After Determination of Ineligibility for Assisted Death: A Case Series J Pain Symptom Manage 2020;60:158e163

9. Wiebe ER, Green S, Wiebe K. Medical assistance in dying (MAiD) in Canada: practical aspects for healthcare teams. July 2020 Annals of Palliative Medicine 9(6):38-38. DOI: 10.21037/apm-19-631

10. Durant K-L, Kortes-Miller K. Physician snapshot: the forming landscape of MAiD in northwestern Ontario. Palliative Care and Social Practice. January 2020. doi:10.1177/2632352420932927

11. Oczkowski SJW, Crawshaw D, Austin P, Frolic A et al. How we can improve the quality of care for patients requesting medical assistance in dying: a qualitative study of health care providers
August 2020Journal of Pain and Symptom Management

12. Munro C, Romanova A, Webber C, Kekewich M, Richard R, Tanuseputro P. Involvement of palliative care in patients requesting medical assistance in dying.
Canadian Family Physician November 2020, 66 (11) 833-842;

13. Brown J, Goodridge D, Harrison A, Thorpe L, Kemp J, Weiler R. Care Considerations in a Patient- and Family-Centered Medical Assistance in Dying Program
August 2020 Journal of palliative care DOI: 10.1177/0825859720951661

14.Thomas McMorrow, Ellen Wiebe, Ruchi Liyanage, Sabrina Tremblay-Huet & Michaela Kelly “Interpreting Eligibility Under the Medical Assistance in Dying Law: The Experiences of Physicians and Nurse Practitioners” (2020) 14:1 McGill JL & Health 51.

15. Freeman LA, Pfaff KA, Kopchek L, Liebman J. Investigating palliative care nurse attitudes towards medical assistance in dying: An exploratory cross-sectional study. Journal of Advanced Nursing. 2020 Feb;76(2):535-545. DOI: 10.1111/jan.14252.

16. Lees C, Gubitz G, Horton R. A Retrospective Review of Medically Assisted Deaths in Nova Scotia: What Do We Know and Where Should We Go? J Palliative Medicine. http://doi.org/10.1089/jpm.2020.0512

17. Gerson S. Assisted dying and palliative care in three jurisdictions: Flanders, Oregon, and Quebec. Annals of palliative medicine 12/04/2020.

18. Selby D, Meaney C, Bean S, Isenberg-Grzeda E. Factors predicting the risk of loss of decisional capacity for medical assistance in dying: a retrospective database review
Citing article Oct 2020 · CMAJ Open

19. Leck E, Christie S, Barry T, Barry S. The preliminary opinion of Canadian spine surgeons on Medical Assistance in Dying (MAID); a cross-sectional survey of Canadian Spine Society (CSS) members Dec 2020 · North American Spine Society Journal (NASSJ)

20. Sabrina Tremblay-Huet, Thomas McMorrow, Ellen Wiebe, Michaela Kelly, Mirna Hennawy, Brian Sum, The impact of the COVID-19 pandemic on medical assistance in dying in Canada and the relationship of public health laws to private understandings of the legal order, Journal of Law and the Biosciences, Volume 7, Issue 1, January-June 2020, lsaa087, https://doi.org/10.1093/jlb/lsaa087

21. Donna E. Stewart, Pierre Viens, Oviya Muralidharan, Patti Kastanias, Justine Dembo, and Ekaterina Riazantseva.E-Survey of Stressors and Protective Factors
in Practicing Medical Assistance in Dying. Journal of Palliative Medicine.ahead of printhttp://doi.org/10.1089/jpm.2020.0664

22. Koksvik G. Practical and ethical complexities of MAiD: Examples from Quebec. November 2020 Wellcome Open Research 5:227 DOI: 10.12688/wellcomeopenres.16306.2

23. Ummel D. De l’importance du sens donné à la mort assistée : l’accompagnement de fin de vie et le processus de deuil en contexte d’aide médicale à mourir
October 2020Frontières 32(1) DOI: 10.7202/1072754ar

24. Frolic A, Swinton M, Murray L, Oliphant A. Double-edged MAiD death family legacy: a qualitative descriptive study. December 2020Supportive and Palliative Care Follow journal
DOI: 10.1136/bmjspcare-2020-002648

25. Mills A, Wortzman R, Bean S, Selby D.Allied Health Care Providers Participating in Medical Assistance in Dying: Perceptions of Support. J Hosp Palliat Nurs. 2020 Jun;22(3):220-8. PMID: 32282557.

26. Zworth M, Saleh C, Ball I, Kalles G, Chkaroubo A, Kekewich M, Miller PQ, Dees M, Frolic A, Oczkowski S. Provision of medical assistance in dying: a scoping review. BMJ Open. 2020 Jul 8;10(7):e036054. PMID: 32641328.

27. Brown, J. Goodridge, D., & Thorpe, L. (2020). Medical assistance in dying in health sciences curricula: A qualitative exploratory study. Canadian Medical Education Journal. DOI: 10.36834/cmej.69325

28. Pesut, B., Thorne, S., Schiller, C., Greig, M., Roussel, J., Tishelman, C. (2020). Constructing good nursing practice for Medical Assistance in Dying in Canada: An Interpretive Descriptive study. Global Qualitative Nursing Research, 7, 1-11 https://journals.sagepub.com/doi/full/10.1177/2333393620938686

29. Pesut, B., Thorne, S., Storch, J., Chambaere, K., Greig, M., Burgess, M. (2020) Riding an elephant. A qualitative study of nurses’ moral journeys in the context of Medical Assistance in Dying (MAiD). Journal of Clinical Nursing, 29(19-20) 3870-3881. http://dx.doi.org/10.1111/jocn.15427

30. Pesut, B., Thorne, S., Schiller, C., Greig, M., Roussel, J. (2020). The rocks and hard places of MAiD: A qualitative study of nursing practice in the context of legislated assisted death. BMC Nursing. Published online February 17, 2020. https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-020-0404-5

2021

1. Wiebe E, Sum B, Kelly M, Hennawy M. Forced and chosen transfers for medical assistance in dying (MAiD) before and during the COVID 19 pandemic: a mixed methods study. Death Studies 2021 (in press)

2. Rosanne Beuthin, Anne Bruce, Marney Thompson, A. E. (Betty) Andersen & Sarah Lundy (2021) Experiences of grief-bereavement after a medically assisted death in Canada: Bringing death to life, Death Studies, DOI: 10.1080/07481187.2021.1876790

3. Rosenblat, J.D. and Li, M. (2021), Is ketamine a litmus test for capacity in assisted dying with depression?. Psycho‐Oncology. https://doi.org/10.1002/pon.5586

4. Wiebe ER, Kelly M, McMorrow T, Trembey-Huet S, Hennawy M. How the experience of medical assistance in dying changed during the COVID-19 pandemic in Canada: a qualitative study of providers. April 2021CMAJ Open 9(2):E400-E405 DOI: 10.9778/cmajo.20200163

5. Ward V, Freeman S, Banner D. Care Provider Perspectives of Medical Assistance in Dying in a Canadian Hospice That Does Not Provide Medical Assistance in Dying Jan 2021 · Canadian Journal of Nursing Research

6. Goldberg R, Nissim R, An E, Hales S. Impact of medical assistance in dying (MAiD) on family caregivers. BMJ Support Palliat Care. 2021 Mar;11(1):107-14. PMID: 30826737.

7. Mathews JJ, Hausner D, Avery J, Hannon B, Zimmermann C, Al-Awamer A.Impact of Medical Assistance in Dying on palliative care: A qualitative study. Palliat Med. 2021 Feb;35(2):447-54. PMID: 33126842.

8. Oliphant A, Frolic AN. Becoming a medical assistance in dying (MAiD) provider: an exploration of the conditions that produce conscientious participation. J Med Ethics. 2021 Jan;47(1):51-58. doi: 10.1136/medethics-2019-105758. Epub 2020 May 5. PMID: 32371593.

9. Brown, J. “Its a big difference between having an opinion on something and actively doing it”: Physician and nurse practitioner non-participation in medical assistance in dying. [Doctoral dissertation, University of Saskatchewan]. https://harvest.usask.ca/handle/10388/13420 2021

10. Brown, J., Goodridge, D., Thorpe, L., & Crizzle, A. (2021) “I am ok with it, but I am not going to do it”: the exogenous factors influencing non-participation in medical assistance in dying. Qualitative Health Research. In Press

11. Brown, J., Goodridge, D., Thorpe, L., & Crizzle, A. (2021) “What is right for me, is not necessarily right for you”: the endogenous factors influencing non-participation in medical assistance in dying. Qualitative Health Research. DOI: 10.1177/10497323211008843

12. Bahji A, Delva N. Making a case for the inclusion of refractory and severe mental illness as a sole criterion for Canadians requesting medical assistance in dying (MAiD): a review April 2021 Journal of Medical Ethics DOI: 10.1136/medethics-2020-107133

13. Nakanishi, A., Cuthbertson, L. & Chase, J. Advance Requests for Medical Assistance in Dying in Dementia: a Survey Study of Dementia Care Specialists. Can Geriatrics J 24, 82–95 (2021).

14. Byram, A. C., Wiebe, E. R., Tremblay-Huet, S. & Reiner, P. B. Advance Requests for MAiD in Dementia: Policy Implications from Survey of Canadian Public and MAiD Practitioners. Canadian Health Policy Journal (2021).

15. Nolen A, Olwi R, Debbie S. Impact of legalization of Medical Assistance in Dying on the Use of Palliative Sedation in a Tertiary Care Hospital: A Retrospective Chart Review. American Journal of Hospice and Palliative Medicine®. July 2021. doi:10.1177/10499091211030443

16. Thangarasa, T., Hales, S., Tong, E. et al. A Race to the End: Family Caregivers’ Experience of Medical Assistance in Dying (MAiD)—a Qualitative Study. J GEN INTERN MED (2021). https://doi.org/10.1007/s11606-021-07012-z

17. Crumley ET, Kelly S, Young J, et alHow is the medical assistance in dying (MAID) process carried out in Nova Scotia, Canada? A qualitative process model flowchart study. BMJ Open 2021;11:e048698. doi: 10.1136/bmjopen-2021-048698

18. Wiebe E, Kelly M, Lalonde K. Oversight of Medical Assistance in Dying (MAiD) in Canada: A Mixed-Methods Report of What We Have and What We Should Have. Canadian Health Policy, August 2021. ISSN 2562-9492

19. Wiebe E, Kelly M. Community characteristics and MAiD uptake in Ontario: an ecological study Canadian Health Policy, August 2021. ISSN 2562-9492

20. Khawaja M, Khawaja A. The Ethics of Dying: Deciphering Pandemic-Resultant Pressures That Influence Elderly Patients’ Medical Assistance in Dying (MAiD) Decisions. Int. J. Environ. Res. Public Health 2021, 18, 8819. https://doi.org/10.3390/ijerph18168819

21. Wright D. “Reflection and soul searching”: Negotiating nursing identity at the fault lines of palliative care and medical assistance in dying. Social science & medicine 2021:114366

22. Simmons JG, Reynolds G, Kekewich M, Downer J, Isenberg SR, Kobewka D. Enduring Physical or Mental Suffering of People Requesting Medical Assistance in Dying 2021 JPSM

23. Ho A, Norman JS, Joolaee S, Serota K. How does Medical Assistance in Dying affect end-of-life care planning discussions? Experiences of Canadian multidisciplinary palliative care providers
2021 Pall Care Soc Pract
DOI: 10.1177/26323524211045996

24. Joolaee S, Ho A, Serota K, Buchman DZ. Medical assistance in dying legislation: Hospice palliative care providers’ perspectives
2021 Nursing Ethics DOI: 10.1177/09697330211012049

25. Stukalin I, Olaiya OR, Naik V, Wiebe E, Kekewich M et al. Medications and Doses used in Medical Assistance in Dying (MAiD): A Retrospective Cohort Study” 2021 Can Med Assos J Open 0268.R2

CAMAP Research Grants awarded September 28, 2021 at the Research Forum

CAMAP Research Awards April 2021

1. Medical Assistance in Dying (MAiD) in 2021: Challenges with Track 2 patients and waivers

2. Exploring the experiences and needs of funeral care providers in supporting individuals and families before, during, and after a MAID death

CAMAP Research Knowledge Transfer Awards April 2021

1. Health care providers’ ethical perspectives on using advance consent for Medical Assistance in Dying (MAiD)

2. Dissemination of Findings from a Scoping Review on Grief and Bereavement Needs Following MAiD

Abstracts presented September 26, 2021, at the Virtual MAiD Research Forum

1. Title: Characteristics of older adults accessing Medical Assistance in Dying (MAiD): a descriptive study.

Authors: Selby, Debbie MD FRCP(C); Chan, Brandon BHSc; Nolen, Amy MBBS CCFP(PC)

Background: Medical Assistance in Dying (MAiD) is an end-of-life option for Canadians accounting for 2% of all deaths in Canada in 2019. Adults over 80 represent a significant proportion of these deaths yet little is known about how they compare with their younger counterparts.

Methods: This study retrospectively reviewed our tertiary care institution’s MAiD database to compare MAiD recipients <65, 65-80, >80 years of age. Extracted data included basic demographics, illness characteristics, functional status, social living arrangements/contacts and outcomes of MAiD assessments.

Results: Of 267 patients assessed for MAiD, 38.2% were over 80. Compared to the younger groups, those over 80 were more likely to be female, to live alone and to be widowed; however, they did not self-identify as ‘socially isolated’. The majority fit into the illness categories of malignancy, cardiopulmonary or neurologic diseases, but those over 80 were more likely to have other more chronic/subacute conditions leading to the MAiD request.
Conclusions: Older adults accessing MAiD are distinct in that they tend to be increasingly frail, without a predominant underlying diagnosis as compared with younger adults, but rather have an accumulation of losses resulting in global functional decline and subsequent loss of autonomy and independence.

2. Title: The experience of people with complex chronic conditions (CCC) who have applied for Medical Assistance in Dying (MAiD)

Authors: Ellen Wiebe, Laura Spiegel, Michaela Kelly, Justine Dembo, Clark Fruhstorfer, Jean-Frederic Menard, Rebecca Dickinson

Background: Since March 2021, the MAiD law includes the provisions of Bill C7. Some individuals who have complex chronic conditions (CCCs) and do not have a reasonably foreseeable natural death are now eligible for MAiD. This study aims to give voice to individuals who experience suffering from a CCC and would like to have an assisted death.

Methods: We conducted a qualitative study using semi-structured interviews. We recruited participants who had previously contacted one of four advocacy organizations about requesting MAiD for suffering related to CCCs. The interviews were audio recorded and transcribed. We conducted thematic analysis in an iterative manner with abductive analysis. As interviews were completed, each investigator reviewed the transcripts, and we discussed emerging themes at regular meetings until we reached consensus.

Results: We spoke with 15 individuals who had diverse experiences living with CCCs. All participants spoke of long-lasting suffering that could not be relieved by the numerous treatments they had tried. Many participants were not rushing to have MAiD at the end of their 90-day waiting period. Instead, they shared that being found eligible for MAiD provided validation that their suffering was “real” and gave them a sense of peace and control. All of the participants distinguished between MAiD and suicide and preferred MAiD; some worried about the risk of failing suicide or the implications for their families. Many thought that MAiD would be peaceful and was more accepted in their communities. Purpose and meaning played a role in participants’ ideas about the future. Some participants shared that their ability to engage in their communities gave them hope for the future or contributed to their desire to delay MAiD. Finally, many participants shared that they felt that they were not taken seriously by health care providers in the past. The research interview seemed to have a therapeutic benefit for the participants because they could share the parts of their suffering and experiences that were important to them.

Discussion: Sharing the voices of individuals with CCCs who are seeking MAiD can provide insight for MAiD assessors and providers as they approach assessing individuals with these conditions.

3. Title. ‘She’s going to burn in hell’: Family members’ experiences with guilt, judgment, and
secrecy during the Medical Assistance in Dying (MAID) process in Canada.

Background. Some literature addresses how family and informal supports (F&IS) experience
guilt, judgment and secrecy about MAID, though none details it. 1-6Thus, we know less about the
F&IS experience during the MAID process. After MAID, F&IS are grieving2 and may feel guilty
if they helped plan and/or support a family member’s death. F&IS may deal with judgment from
their family, friends and others and decide to keep MAID a secret. 5 A lack of social support and
secrecy about MAID may exacerbate F&IS grieving process.5-6

Methods. We conducted one-hour semi-structured interviews with F&IS of people who received
MAID in Canada. Nova Scotia recruitment was done by the MAID Access and Resource Team’s
Nurse Navigator. Others were recruited from study advertisements posted by Dying with Dignity
Canada and Bridge C-14.

Results. The majority of F&IS experienced judgment from others, including healthcare
providers, especially if those people were religious. This led to many participants engaging in
some form of secrecy about MAID (e.g., they never told anyone or they selectively told a few
people). A significant number experienced guilt and trauma from being involved in MAID. As
MAID focuses on the patient, family members have little support.

Discussion. There is a need for F&IS MAID resources and support. MAID assessors, providers
and programs should offer support and information to F&IS throughout the MAID process, not
only the patient.

Authors. Jocelyne LeBlanc, Erika Leck MD, Alexandra Malley MD, Ellen T. Crumley PhD.

Contact Information. On behalf of all authors: Jocelyne LeBlanc, email: x2019ajr@stfx.ca and
Dr. Ellen T Crumley, email: ecrumley@stfx.ca.