Medical assistance in dying (MAiD): Canadian nurses’ experiences

Abstract

Medical assistance in dying (MAiD) represents a historic change in Canadian society and the provision of end‐of‐life care. In this descriptive narrative inquiry, 17 nurses were interviewed during the first 6 months of assisted dying becoming a legal option for patients in Canada. Nurses’ experiences of either providing care for a patient who had chosen MAiD, or declining to participate in MAiD, were explored. Findings describe three themes and eight storylines of the impact of MAiD on nurses’ view of the profession, clinical practice, and personally. While most nurses perceived MAiD as an extension of the profession and their nursing practice, a small number also expressed moral distress as they grappled with assisted dying. Narratives illustrated an ongoing sensemaking process and spectrum of emotions. These findings offer insight and provide direction for nurses and managers in this new clinical and legal reality. Further research is needed to understand more fully the moral distress of some nurses, as well as the importance of communicating openly and nonjudgmentally with patients, families, and the health‐care team.

Medical assistance in dying: A political issue for nurses and nursing in Canada

“…Such difficulties were further highlighted in a recent descriptive narrative inquiry by Beuthin et al (). In this study, 17 nurses were interviewed about their experience of MAiD.…”

“…Similar to countries such as Belgium and Switzerland, and to certain states within the United States of America, Canada has undergone legal transitions that support new end‐of‐life options for patients (Beuthin, Bruce, & Scaia, ). In 2015, physician‐assisted suicide was legalized in Canada through the Carter v. Canada (Attorney General) decision.…”

“…for patients (Beuthin, Bruce, & Scaia, 2018). In 2015, physician-assisted suicide was legalized in Canada through the Carter v. Canada (Attorney General) decision.…”

But it’s legal, isn’t it? Law and ethics in nursing practice related to medical assistance in dying

“…However, preliminary evidence from nurses in Canada suggests that this process is a bit more complicated than it might initially appear. Nurses may not necessarily be confident in their initial moral positioning but rather need to work it out over time (Beuthin, Bruce, & Scaia, ). This shouldn't surprise us when we realize that much of the willingness to participate in MAiD is related to family and peer influences (Lavoie et al, ) and, as society becomes more familiar with MAiD and the views of such influencers evolve, nurses’ moral comfort with the act may evolve over time as well.…”

Nurses’ attitudes to euthanasia eleven years on: Has anything changed?

“…A descriptive narrative study of 17 nurses across Vancouver Island providing care for a patient who had chosen MAID or declined to participate in the first 6 months following legalization found that most participants saw MAID as an extension of the profession and nursing practice. However, while there is some discussion regarding siting and starting intravenous infusions, it is not clear how directly involved in MAID the nurses were (Beuthin, Bruce, & Scaia, ). While it is still too early to assess the full impact of MAID on nursing practice, the Canadian Nurses Association has provided guidance and recognizes that “ nurses have a unique perspective and bring an important contribution to the healthcare team in the provision of palliative and end‐of‐life care that includes MAID” (Canadian Nurses Association, p 24).…”