Forced and chosen transfers for medical assistance in dying (MAiD) before and during the COVID 19 pandemic: A mixed methods study

The impact of coronavirus disease 2019 on medical assistance in dying

“…Recent published literature on the impact of COVID-19 on MAiD can be described under the following categories: studies investigating the impact of COVID-19 on MAiD from the healthcare providers’ perspective [ 7 , 8 , 9 ▪ , 10 , 11 , 12 ▪▪ ]; studies investigating the impact of COVID-19 on MAiD from the patient/family perspective [ 13 ]; and literature that reviews the impact of COVID-19 on MAiD from a legal–ethical perspective [ 14 , 15 ]. All publications, except two [ 11 , 15 ], were situated in Canada.…”

“…Ongoing studies in Canada on the implementation of MAiD were able to pivot quickly to respond to questions brought on by the pandemic. All studies collected data during the earlier phases of the COVID-19 pandemic, with most reporting on data collected up until July 2020 [ 7 , 8 , 9 ▪ , 10 ] and only two including data collected in 2021 [ 11 , 13 ].…”

“…Four studies involved surveys or qualitative interviews with MAiD providers and reported on the impact of COVID-19 on MAiD from their perspective. All of these studies were either conducted in Canada [ 7 , 8 , 9 ▪ , 10 ] or included mostly Canadian participants [ 11 , 12 ▪▪ ].…”

“…Lastly, Wiebe et al [ 10 ] in a study focusing on forced or chosen transfers of patients from one location to another for MAiD, conducted 13 interviews with MAiD providers across Canada from April to May 2020 in order to understand how the pandemic impacted MAiD-related transfers. The study reported that the pandemic decreased the choices of a location for MAiD and made the already challenging logistics involved in chosen transfers for MAiD more difficult.…”

Medical Assistance in Dying (MAiD) for Canadian Prisoners: A Case Series of Barriers to Care in Completed MAiD Deaths

“…All three physicians believe that enforcing a transfer to a community hospital as the sole option of location for MAiD is a “forced transfer”**: a common barrier to patient-centered care in MAiD. 15 Physician knowledge of location of death may be a barrier to provision of patient-centered care, should they discover discrepancies in reported preference. Finally, CSC's guideline details that the first MAiD assessment be conducted by an internal physician, which did not occur in Case 1 or Case 2.…”