Professional experiences of formal healthcare providers in the provision of medical assistance in dying (MAiD): A scoping review

Abstract

Objective This scoping review describes the existing literature which examines the breadth of healthcare providers’ (HCP's) experiences with the provision of medical assistance in dying (MAiD). Method This study employed a scoping review methodology: (1) identify research articles, (2) identify relevant studies, (3) select studies based on inclusion/exclusion criteria, (4) chart the data, and (5) summarize the results. Results In total, 30 papers were identified pertaining to HCP's experiences of providing MAiD. Fifty-three percent of the papers were from Europe (n = 16) and 40% of studies were from the USA or Canada (n = 12). The most common participant populations were physicians (n = 17) and nurses (n = 12). This scoping review found that HCPs experienced a variety of emotional responses to providing or providing support to MAiD. Some HCPs experienced positive emotions through helping patients at the end of the patient's life. Still other HCPs experienced very intense and negative emotions such as immense internal moral conflict. HCPs from various professions were involved in various aspects of MAiD provision such as responding to initial requests for MAiD, supporting patients and families, nursing support during MAiD, and the administration of medications to end of life. Significance of results This review consolidates many of the experiences of HCPs in relation to the provision of MAiD. Specifically, this review elucidates many of the emotions that HCPs experience through participation in MAiD. In addition to describing the emotional experiences, this review highlights some of the roles that HCPs participate in with relation to MAiD. Finally, this review accentuates the importance of team supports and self-care for all team members in the provision of MAiD regardless of their degree of involvement.

Conscientious Objection and Other Motivations for Refusal to Treat in Hastened Death: A Systematic Review

“…Participation in hastened death procedures can have a negative impact on HCP [52]. To be required to perform a procedure that goes against the convictions of the HCP is often associated with moral distress, which is in turn often associated with negative consequences on health [33,53,54].…”

Practice and challenges for organ donation after medical assistance in dying: A scoping review including the results of the first international roundtable in 2021

“…Concerns can extend to all involved 175–177 . Literature emphasizes the importance of healthcare providers participating voluntarily in the ethically sensitive environment of ODE 111,174,176,178–184 …”

“…175 , 176 , 177 Literature emphasizes the importance of healthcare providers participating voluntarily in the ethically sensitive environment of ODE. 111 , 174 , 176 , 178 , 179 , 180 , 181 , 182 , 183 , 184 …”

Palliative care providers’ roles in medical assistance in dying decision-making triads with patients and families: A qualitative analysis

“…Some family members take a more active role and others take a more passive or supportive role in decision-making (Gamondi et al 2015;Thangarasa et al 2021). Likewise, clinicians may take more active or passive roles in relation to MAiD based on their personal and professional values and experiences (Fujioka et al 2018;Ward et al 2021). Clinicians experience myriad emotions in relation to MAiD decision-making, including satisfaction from fulfilling patients' end-of-life wishes, to emotional stress, distress, and anxiety (Beuthin et al 2021;Joolaee et al 2022;Ward et al 2021).…”

“…Likewise, clinicians may take more active or passive roles in relation to MAiD based on their personal and professional values and experiences (Fujioka et al 2018;Ward et al 2021). Clinicians experience myriad emotions in relation to MAiD decision-making, including satisfaction from fulfilling patients' end-of-life wishes, to emotional stress, distress, and anxiety (Beuthin et al 2021;Joolaee et al 2022;Ward et al 2021). Patients, families, and clinicians often compromise to achieve the best possible death experience for the patient (Oczkowski et al 2021).…”