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

26. Shapiro GK, Tong E, Nissim R, et al. Exploring key stakeholders’ attitudes and opinions on medical assistance in dying and palliative care in Canada: a qualitative study protocolBMJ Open 2021;11:e055789. doi: 10.1136/bmjopen-2021-055789

27. Peter Driftmier and Jessica Shaw. Medical Assistance in Dying (MAiD) for Canadian Prisoners: A Case Series of Barriers to Care in Completed MAiD Deaths. Health Equity.Dec 2021.847-853.http://doi.org/10.1089/heq.2021.0117

28. Selby D, Chan B, Nolen A. Characteristics of Older Adults Accessing Medical Assistance in Dying (MAiD): a Descriptive Study. Can Geriatr J [Internet]. 2021 Dec. 1 [cited 2022 Jan. 11];24(4):312-8. Available from: https://cgjonline.ca/index.php/cgj/article/view/520

29. Thériault, V., Guay, D. & Bravo, G. (2021). Extending Medical Aid in Dying to Incompetent Patients: A Qualitative Descriptive Study of the Attitudes of People
Living with Alzheimer’s Disease in Quebec. Canadian Journal of Bioethics /Revue canadienne de bioéthique, 4(2), 69–77. https://doi.org/10.7202/1084452ar

30. Donna E. Stewart, Pierre Viens, Oviya Muralidharan, Patti Kastanias, Justine Dembo, and Ekaterina Riazantseva. E-Survey of Stressors and Protective Factors in Practicing MAID.” Journal of Palliative Medicine.Sep 2021.1489-1496.http://doi.org.www.proxy.cpsbc.ca/10.1089/jpm.2020.0664

31. Hashemi N, Amos E, Lokuge B. Quality of Bereavement for Caregivers of Patients Who Died by Medical Assistance in Dying at Home and the Factors Impacting Their Experience: A Qualitative Study. J Palliat Med. 2021 Sep;24(9):1351-1357. doi: 10.1089/jpm.2020.0654. Epub 2021 Jan 29. PMID: 33513049.

32. R. Shour, M. Li. A Geriatric MAiD Request in Primary Care: Understanding Eligibility and Promoting a Patient-Centred Approach. Canadian Family Physician, 67(9):675-677, 2021.

33. M. Li*, G.K. Shapiro*, R. Klein, A. Barbeau, A. Rydall, J.A.H. Bell, R. Nissim, S. Hales, C. Zimmermann, R.K.S. Wong, G. Rodin. Medical Assistance in Dying in Patients with Advanced Cancer and their Caregivers: A Mixed Methods Longitudinal Study Protocol, BMC Palliative Care, 20(1):117, 2021.

34. Climans, S. A., Mason, W. P., Edelstein, K., Variath, C., & Bell, J. A., (2021). Neuro-oncology clinicians’ attitudes and perspectives on medical assistance in dying. Canadian Journal of Neurological Sciences. 1-20. https://doi.org/10.1017/cjn.2021.186

35. Pesut B, Wright DK, Thorne S, Hall MI, Puurveen G, Storch J, Huggins M. What’s suffering got to do with it? A qualitative study of suffering in the context of Medical Assistance in Dying (MAID).BMC Palliat Care. 2021 Nov 11;20(1):174. PMID: 34758799.

36. Pesut B, Thorne S, Wright DK, Schiller C, Huggins M, Puurveen G, Chambaere K. Navigating medical assistance in dying from Bill C-14 to Bill C-7: a qualitative study. BMC Health Serv Res. 2021 Nov 4;21(1):1195. PMID: 34736463.

2022

1. Shaw J, Driftmier P. “Dying with a Smile, Just Knowing that Somebody’s Listened to Me”: End-Of-Life Care and Medical Assistance in Dying in Canadian Prisons. OMEGA – Journal of Death and Dying. December 2022. doi:10.1177/00302228211052341

2. Variath, C., Peter, E., Cranley, L. et al. Health care providers’ ethical perspectives on waiver of final consent for Medical Assistance in Dying (MAiD): a qualitative study. BMC Med Ethics 23, 8 (2022). https://doi.org/10.1186/s12910-022-00745-4

3. Ellen R. Wiebe, Michaela Kelly, Laura Spiegel, Jean-Frederic Menard, Emily Hawse & Rebecca Dickinson (2022) Are unmet needs driving requests for Medical Assistance in Dying (MAiD)? A qualitative study of Canadian MAiD providers, Death Studies, DOI: 10.1080/07481187.2022.2042754

4. Philippe Laperle, Marie Achille, Deborah Ummel. To Lose a Loved One by Medical Assistance in Dying or by Natural Death with Palliative Care: A Mixed Methods Comparison of Grief Experiences
April 2022OMEGA–Journal of Death and Dying Follow journal
DOI: 10.1177/00302228221085191

5. Watson L, Link C, Qi S, DeIure A, Russell KB, Schulte F, Forbes C, Silvius J, Kelly B, Bultz BD. Symptom Burden and Complexity in the Last 12 Months of Life among Cancer Patients Choosing Medical Assistance in Dying (MAID) in Alberta, Canada. Curr Oncol. 2022 Mar 3;29(3):1605-1618. doi: 10.3390/curroncol29030135. PMID: 35323335; PMCID: PMC8947648.

6. Kortes-Miller K, Durant KL.Physician experiences with medical assistance in dying: Qualitative study in northwestern Ontario. Can Fam Physician. 2022 May;68(5):e161-e8. PMID: 35552203.

7. Tauh S, Nickel D, Thorpe L, Brown J, Linassi G. Perspectives on medical assistance in dying amongst persons with traumatic spinal cord injury: a qualitative study. Spinal Cord. 2022 May;60(5):465-9. PMID: 35396457.

8. Janine Penfield Winters , Neil Pickering and Chrystal Jaye. Winging it: a qualitative study of knowledge-acquisition experiences for early adopting providers of medical assistance in dying. Palliative Care & Social Practice 2022, Vol. 16: 1–12

9. Gupta M, Blouin S. Ethical judgment in assessing requests for medical assistance in dying in Canada and Quebec: What can we learn from other jurisdictions? Death Stud. 2022;46(7):1608-1620. doi: 10.1080/07481187.2021.1926636. Epub 2021 Jun 7. PMID: 34097584.

10. Dholakia SY, Bagheri A, Simpson A. Emotional impact on healthcare providers involved in medical assistance in dying (MAiD): a systematic review and qualitative
meta-synthesis. BMJ Open 2022;12:e058523. doi:10.1136/bmjopen-2021-058523

11. Rinat Nissim, Sarah Hales. The impact of coronavirus disease 2019 on medical assistance in dying. Curr Opin Support Palliat Care. 2022 Sep 1;16(3):125-9. PMID: 35862889.

12. Worthington A, Finlay I, Regnard C. Efficacy and safety of drugs used for ‘assisted dying’. Br Med Bull. 2022 Jul 9;142(1):15-22. doi: 10.1093/bmb/ldac009. PMID: 35512347; PMCID: PMC9270985.

13. Sera Whitelaw, Trudo Lemmens, Harriette G C Van Spall. The Expansion of Medical Assistance in Dying in the COVID-19 Pandemic Era and Beyond: Implications for Vulnerable Canadians
May 2022Canadian Journal of General Internal Medicine 17(2):17-21 DOI: 10.22374/cjgim.v17i2.586

14. Andrea Frolic3, Marilyn Swinton, Allyson Oliphant, Leslie Murray, Paul Miller. Access Isn’t Enough: Evaluating the Quality of a Hospital Medical Assistance in Dying Program. August 2022 HEC Forum DOI: 10.1007/s10730-022-09486-8

15. Serge Daneault, Mehdi Azri, Deborah Ummel, Sylvie Gendron. Non-somatic Suffering in Palliative Care: A Qualitative Study on Patients’ Perspectives. March 2022 Journal of Palliative Care 37(9):082585972210834 DOI: 10.1177/08258597221083421

16. Han Yan, Jessica Bytautas, Sarina Roslyn Isenberg, Tekla Hendrickson. Grief and bereavement of family and friends around medical assistance in dying: scoping review September 2022 Supportive and Palliative Care DOI: 10.1136/spcare-2022-003715

17. LeBlanc, S., MacDonald, S., Martin, M. et al. Development of learning objectives for a medical assistance in dying curriculum for Family Medicine Residency. BMC Med Educ 22, 167 (2022). https://doi.org/10.1186/s12909-022-03204-1

CAMAP Research Grants awarded June 1, 2022 at the Research Forum

1. Evaluating The Medical Assistance in Dying (MAiD) Program from a Patient’s and Family’s Perspective across Vancouver Coastal Health Authority (VCH) $2,927.81 Felor Javadi Bashar et al
2. Use of palliative sedation over time: a mixed-methods study of palliative care providers $1,125.00 Amy Nolen et al
3. Exploring Medical Assistance in Dying (MAiD) Utilization Variability in British Columbia $2,500.00 Rosanne Beuthin et al

Abstracts presented June 1, 2022, at the MAiD Research Forum

#1 – Trouton, Konia
ABSTRACT
Work in Progress
Title: Best Modalities for End-of-life Communication Learning
Background: Healthcare providers in Canada are facing an ongoing need for education in End-of-life (EOL) communications to support patient-centered care. In particular, with the decriminalization of assisted dying, more clinicians seek some enhanced skills in end-of-life conversations. A variety of tools and training initiatives have been created in the field to assist. Yet, little is known about the usefulness of those interventions to clinicians and patients.This literature review aims to highlight the most effective modalities for continued practitioner education in EOL communications with the patients and families, so that the lessons learned can be applied to teaching initiatives that include MAiD.
Methods: An extensive search of literature was performed, focussing on English language publications from 2011-2021. Publications were analyzed by rapid review, and discarded if not relevant. The remaining studies were categorized by type of learner, method of teaching, involvement of patients/families, and long term follow up. These sections were analyzed for pearls for future initiatives. Preliminary findings: The communication training varies through disciplines, as does quality of the programs. To date, there is no standard EOL conversations curriculum for practitioners. Very few programs test their impacts on patient care. Many were created out of urgency, their longer-term benefits are under-reported. Mid-career professionals have fewer opportunities for education than early-career. Criteria for outstanding programs appear to be those strong design, well-measured efficacy, many incorporated interdisciplinary and/ or experiential learning, assessed learners’ progress long-term, and some engaged care recipients’ perspectives. These studies could serve as concepts towards building a
national EOL communications curriculum, as well as inspiring examples of effective training and responsible research.
Authors: *Konia Trouton, MD MPH FCFP, Clinical Professor, Department of Family Medicine UBC &
UVIC. (konia.trouton@islandhealth.ca)
Brittany Clark, B.A, B.SW., Victoria Hospice Education and Research
Jolanta Vaitekonyte, B.A., Victoria Hospice Education and Research
04/05/2022

#2 – Serota, Kristie
Research in Progress Abstract:
CAMAP Research Forum Program Submission
Title: Life after MAiD: Loved ones’ stories of disagreement and bereavement
Background: International research finds that family conflict and disagreement impact loved ones’ grief and bereavement experiences following medical assistance in dying (MAiD). Loved
ones who are less supportive of the MAiD decision or more passively involved in the process may experience more significant moral dilemmas and challenging grief than those with active
involvement. The fear of stigma can result in selective disclosure of the cause of death, secrecy, social isolation, and disenfranchised grief. A lack of social support may compound grief and
mental health challenges following MAiD. This is the first study to examine how disagreement impacts MAiD bereavement in Canada.
Methods: This qualitative research project uses poststructural narrative inquiry. We are conducting 15-20 interviews with bereaved loved ones across Canada. Data is being discursively
analyzed to examine constructions of power, resistance, and agency in participants’ stories. Quilting is being used as a creative analytic practice to represent salient themes and as a medium
for knowledge translation with public audiences.
Ethics: This study has been approved by the University of Toronto’s research ethics board. Implications & Dissemination: Findings from this study may inform future research, clinical,
and regulatory directions that can enhance loved ones’ well-being as they navigate MAiD bereavement. We will contribute to the continued improvement of publicly available MAiD
bereavement resources. Findings can inform resources for clinicians to help families navigate conflict or disagreement about MAiD. Finally, this research may be used to inform future
policies and resources regarding family involvement in MAiD in Canada and abroad.
Kristie Serota
MA, PhD Candidate
Dalla Lana School of Public Health and the Joint Centre for Bioethics
University of Toronto
kristie.serota@mail.utoronto.ca

#3 – Haegedorn, Kathryn
Title: Provider experiences using waivers of final consent for Medical Assistance in Dying
(MAiD) in Canada
Background: In March 2021, the Canadian MAiD law was amended so that individuals who have been assessed and approved for MAiD, and have a reasonably foreseeable natural death, can
use a waiver of final consent. Canada is the only jurisdiction with this option. This study aims to understand the experience of MAiD providers using waivers of final consent during the first
year of use.
Methods: This is a qualitative study using semi-structured interviews. MAiD providers were contacted by CAMAP and invited to participate. Interviews were conducted by phone or video.
The interviews were audio-recorded, transcribed verbatim and anonymized. Data collection and analysis was done in an iterative manner. Recruitment for the study is ongoing and will
continue until theme saturation is reached.
Results: Overall, participants were relieved to have the ability to use waivers of final consent. Many reported difficulty in explaining the waiver to patients and felt that consenting to a
waiver required more capacity than consenting to MAiD. In some cases, there was confusion for patients and families about the difference between a waiver of final consent and an advanced
directive, and this resulted in distressing conversations.
Discussion: Though new challenges have resulted from the use waivers, most participants agree that waivers are a useful and important addition to their MAiD practice.
Implications: Our findings identify challenges that providers experience when using waivers of final consent and the solutions that they implement to improve the process. This will help to
increase the usability of waivers among providers and improve patient care.
Authors:
Kathryn Haegedorn
Michaela Kelly
Kate Fitzsimmons
Ellen Wiebe
Contact: katmh@student.ubc.ca

#4 – Kelly, Michaela
Title: Clinician experiences assessing and providing MAiD for individuals without reasonably
foreseeable natural death
Background: In March 2021, the Canadian MAiD law was amended so that some people who do not have a reasonably foreseeable natural death may now be eligible for MAiD. Working with
these patients (Track 2 patients) is a new area of medical practice. This study aims to understand the experience of MAiD providers during the first year of the amended law.
Methods: This is a qualitative study using semi-structured interviews. MAiD providers were contacted by the CAMAP administrator and invited to participate in a phone or video interview. Interviews are audio-recorded and transcribed verbatim. Data collection and thematic analysis is done in an iterative manner. We aim to speak with 20 participants (8 completed to date), and recruitment will continue until we reach theme saturation.
Results: All participants felt that assessing Track 2 patients was time-intensive and sometimes emotionally taxing. Participants shared that a patient’s young age or concurrent mental illness
can make Track 2 cases particularly challenging. Many had experiences in which a Track 2 patient had not received adequate care prior to their MAiD assessment, and participants had
different approaches to this. Some became the primary care provider, most referred to other clinicians and some refused to assess until the patient had been assessed and treated by the
appropriate specialists.
Discussion: Assessing and providing MAiD for individuals without a reasonably foreseeable natural death has led to new challenges for clinicians. There is wide variability in how clinicians
approach these challenges.
Implications: These findings can inform education for the CAMAP membership about approaching MAiD assessment for Track 2 patients.
Authors:
Michaela Kelly
Kathryn Haegedorn
Kate Fitzsimmons
Ellen Wiebe
Contact: michaelakmkelly@gmail.com

#5 Fitzsimmons, Kate
Title: Challenges in recruiting and retaining assessors and providers of Medical Assistance in
Dying (MAiD) in Canada
Background: Canadians have had the right to an assisted death since 2016, but exercising this right depends on willing clinicians being available to provide MAiD. In 2020, MAiD deaths
accounted for 2.5% of all deaths in Canada. Assessors and providers have expressed concern about increasing workloads and program sustainability.
Method: We conducted an online questionnaire of MAiD assessors, providers and coordinators/navigators. The questionnaires included open and closed questions about
workloads and how to keep MAiD sustainable. We collected demographic information about province, MAiD experience, and whether they are physicians or nurse practitioners. Descriptive
analyses were performed on the quantitative data and qualitative comments were analyzed to provide context.
Results: There were 78 MAiD providers (68 MDs and 10 NPs), 7 assessors, and 5 coordinators who responded to the survey from 9 provinces and territories. The clinicians ranged in age from
29 to 84 years, and 43.5% plan to change their workload in the next five years. Of these, 32.4% intend to decrease or stop their MAiD work. A high workload burden, insufficient
compensation, and a lack of administrative support were the main reported barriers to continuing participation in MAiD provision and assessment. Four (80%) of the coordinators
stated they had too few clinicians, and the wait times ranged from 0-12 weeks for Track 1 patients and from 0-40 weeks for Track 2 patients.
Discussion: These findings support concerns previously expressed by clinicians regarding
personnel retainment and program continuation.
Implications: The results can help CAMAP and its members improve the sustainability of MAiD
care.
Authors:
Michaela Kelly
Kate Fitzsimmons
Dr. Ellen Wiebe – ellenwiebe@gmail.com