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

Published online by Cambridge University Press:  30 March 2021

Valerie Ward ,
Shannon Freeman Open the ORCID record for Shannon Freeman [Opens in a new window] ,
Taylor Callander  and
Beibei Xiong Open the ORCID record for Beibei Xiong [Opens in a new window]
Valerie Ward
Affiliation:
Northern Medical Program, University of Northern British Columbia, Prince George, BC, Canada
Shannon Freeman*
Affiliation:
School of Nursing, University of Northern British Columbia, Prince George, BC, Canada
Taylor Callander
Affiliation:
Northern Medical Program, University of Northern British Columbia, Prince George, BC, Canada
Beibei Xiong
Affiliation:
School of Health Sciences, University of Northern British Columbia, Prince George, BC, Canada
*
Author for correspondence: Shannon Freeman, Associate Professor, School of Nursing, University of Northern British Columbia, 3333 University Way, Prince George, BC, Canada V2N 4Z9. E-mail: [email protected]
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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.

Keywords

EuthanasiaExperiencesHealthcare providersMedical assistance in dyingPhysician-assisted suicide
Type
Review Article
Information
Palliative & Supportive Care , Volume 19 , Issue 6 , December 2021 , pp. 744 - 758
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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References

REFERENCES

Ablett, JR and Jones, RSP (2007) Resilience and well-being in palliative care staff: A qualitative study of hospice nurses’ experience of work. Psycho-Oncology 16(8), 733–740. doi:10.1002/pon.1130.CrossRefGoogle Scholar
Beuthin, R, Bruce, A and Scaia, M (2018) Medical assistance in dying (MAiD): Canadian nurses’ experiences. Nursing Forum 53(4), 511–520. doi:10.1111/nuf.12280.CrossRefGoogle ScholarPubMed
Bilsen, JJR, Vander Stichele, RH, Mortier, F, et al. (2004) Involvement of nurses in physician-assisted dying. Journal of Advanced Nursing 47(6), 583–591. doi:10.1111/j.1365-2648.2004.02982.x.CrossRefGoogle ScholarPubMed
Boroujeni, AZ, Mohammadi, R, Oskouie, SFH, et al. (2009) Iranian nurses’ preparation for loss: Finding a balance in end-of-life care: Nurses’ preparation for loss. Journal of Clinical Nursing 18(16), 2329–2336. doi:10.1111/j.1365-2702.2008.02437.x.CrossRefGoogle ScholarPubMed
Boudreau, JD and Somerville, MA (2013) Euthanasia is not medical treatment. British Medical Bulletin 106(1), 45–66. doi:10.1093/bmb/ldt010.CrossRefGoogle Scholar
Braverman, DW, Marcus, BS, Wakim, PG, et al. (2017) Health care professionals’ attitudes about physician-assisted death: An analysis of their justifications and the roles of terminology and patient competency. Journal of Pain and Symptom Management 54(4), 538–545.e3. doi:10.1016/j.jpainsymman.2017.07.024.CrossRefGoogle ScholarPubMed
British Columbia College of Nurse Professionals (2020) Scope of practice for nurse practitioners. Retrieved Dec, 3 2020, from British Columbia Nurse College of Nurse Professionals. Available at: https://www.bccnm.ca/Documents/standards_practice/np/NP_ScopeofPractice.pdf.Google Scholar
Browall, M, Henoch, I, Melin-Johansson, C, et al. (2014) Existential encounters: Nurses’ descriptions of critical incidents in end-of-life cancer care. European Journal of Oncology Nursing 18(6), 636–644. doi:10.1016/j.ejon.2014.06.001.CrossRefGoogle ScholarPubMed
Buiting, HM, Gevers, JKM, Rietjens, JAC, et al. (2008) Dutch criteria of due care for physician-assisted dying in medical practice: A physician perspective. Journal of Medical Ethics 34(9), e12.10.1136/jme.2008.024976CrossRefGoogle ScholarPubMed
Cohen, J, Van Wesemael, Y, Smets, T, et al. (2012) Cultural differences affecting euthanasia practice in Belgium: One law but different attitudes and practices in Flanders and Wallonia. Social Science & Medicine (1982) 75(5), 845–853. doi:10.1016/j.socscimed.2012.04.021.CrossRefGoogle ScholarPubMed
Colquhoun, HL, Levac, D, O'Brien, KK, et al. (2014) Scoping reviews: Time for clarity in definition, methods, and reporting. Journal of Clinical Epidemiology 67(12), 1291–1294. doi:10.1016/j.jclinepi.2014.03.013.CrossRefGoogle ScholarPubMed
Corley, MC, Minick, P, Elswick, RK, et al. (2005) Nurse moral distress and ethical work environment. Nursing Ethics 12(4), 381–390. doi:10.1191/0969733005ne809oa.CrossRefGoogle ScholarPubMed
Davis, K, Drey, N and Gould, D (2009) What are scoping studies? A review of the nursing literature. International Journal of Nursing Studies 46(10), 1386–1400. doi:10.1016/j.ijnurstu.2009.02.010.CrossRefGoogle ScholarPubMed
De Bal, N, Dierckx de Casterlé, B, De Beer, T, et al. (2006) Involvement of nurses in caring for patients requesting euthanasia in Flanders (Belgium): A qualitative study. International Journal of Nursing Studies 43(5), 589–599. doi:10.1016/j.ijnurstu.2005.08.003.CrossRefGoogle ScholarPubMed
De Bal, N, Gastmans, C and Dierckx de Casterlè, B (2008) Nurses’ involvement in the care of patients requesting euthanasia: A review of the literature. International Journal of Nursing Studies 45(4), 626–644.Google ScholarPubMed
De Beer, T, Gastmans, C and De Casterle, BD (2004) Involvement of nurses in euthanasia: A review of the literature. Journal of Medical Ethics 30(5), 494–498. doi:10.1136/jme.2003.004028.CrossRefGoogle ScholarPubMed
De Casterlé, BD, Verpoort, C, De Bal, N, et al. (2006) Nurses’ views on their involvement in euthanasia: A qualitative study in Flanders (Belgium). Journal of Medical Ethics 32(4), 187–192. doi:10.1136/jme.2005.011783.CrossRefGoogle Scholar
Dees, MK, Vernooij-Dassen, MJ, Dekkers, WJ, et al. (2013) Perspectives of decision-making in requests for euthanasia: A qualitative research among patients, relatives and treating physicians in the Netherlands. Palliative Medicine 27(1), 27–37. doi:10.1177/0269216312463259.CrossRefGoogle ScholarPubMed
Denier, Y, De Casterlé, BD, De Bal, N, et al. (2009) Involvement of nurses in the euthanasia care process in Flanders (Belgium): An exploration of two perspectives. Journal of Palliative Care 25(4), 264–274.10.1177/082585970902500404CrossRefGoogle ScholarPubMed
Denier, Y, Dierckx de Casterlé, B, De Bal, N, et al. (2010) “It's intense, you know.” Nurses’ experiences in caring for patients requesting euthanasia. Medicine, Health Care, and Philosophy 13(1), 41–48. doi:10.1007/s11019-009-9203-1.CrossRefGoogle ScholarPubMed
Dierckx de Casterlé, B, Denier, Y, De Bal, N, et al. (2010) Nursing care for patients requesting euthanasia in general hospitals in Flanders, Belgium: Nursing care for patients requesting euthanasia. Journal of Advanced Nursing 66(11), 2410–2420. doi:10.1111/j.1365-2648.2010.05401.x.CrossRefGoogle ScholarPubMed
Dobscha, SK, Heintz, RT, Press, N, et al. (2004) Oregon physicians’ responses to requests for assisted suicide: A qualitative study. Journal of Palliative Medicine 7(3), 451–461. doi:10.1089/1096621041349374.CrossRefGoogle ScholarPubMed
Elmore, J, Wright, DK and Paradis, M (2016) Nurses’ moral experiences of assisted death. Nursing Ethics. doi:10.1177/0969733016679468.Google ScholarPubMed
Fosse, A, Ruths, S, Malterud, K, et al. (2017) Doctors’ learning experiences in end-of-life care – A focus group study from nursing homes. BMC Medical Education 17(1). doi:10.1186/s12909-017-0865-8.CrossRefGoogle ScholarPubMed
Francke, AL, Albers, G, Bilsen, J, et al. (2016) Nursing staff and euthanasia in the Netherlands. A nation-wide survey on attitudes and involvement in decision making and the performance of euthanasia. Patient Education and Counseling 99(5), 783–789. doi:10.1016/j.pec.2015.11.008.CrossRefGoogle ScholarPubMed
Fujioka, JK, Mirza, RM, McDonald, PL, et al. (2018) Implementation of medical assistance in dying: A scoping review of health care providers’ perspectives. Journal of Pain and Symptom Management 55(6), 1564–1576.e9. doi:10.1016/j.jpainsymman.2018.02.011.CrossRefGoogle ScholarPubMed
Ganzini, L, Nelson, H, Schmidt, T, et al. (2000) Physicians’ experiences with the Oregon Death with Dignity Act. New England Journal of Medicine 342(8), 557–563. doi:10.1056/NEJM200002243420806.CrossRefGoogle ScholarPubMed
Ganzini, L, Nelson, HD, Lee, MA, et al. (2001) Oregon physicians’ attitudes about and experiences with end-of-life care since passage of the Oregon Death with Dignity Act. JAMA 285(18), 2363–2369.10.1001/jama.285.18.2363CrossRefGoogle ScholarPubMed
Ganzini, L, Harvath, T, Jackson, A, et al. (2002) Experiences of Oregon nurses and social workers with hospice patients wrequested assistance with suicide. New England Journal of Medicine 347(8), 582–588. doi:10.1056/NEJMsa020562.CrossRefGoogle ScholarPubMed
Georges, J-J, The, AM, Onwuteaka-Philipsen, BD, et al. (2008) Dealing with requests for euthanasia: A qualitative study investigating the experience of general practitioners. Journal of Medical Ethics 34(3), 150–155. doi:10.1136/jme.2007.020909.CrossRefGoogle ScholarPubMed
Gielen, J, van den Branden, S and Broeckaert, B (2009) Religion and nurses’ attitudes to euthanasia and physician assisted suicide. Nursing Ethics 16(3), 303–318. doi:10.1177/0969733009102692.CrossRefGoogle ScholarPubMed
Government of Canada (2017) Medical assistance in dying. Retrieved November 12, 2017, from Medical assistance in dying. Available at: https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html.Google Scholar
Granek, L, Mazzotta, P, Tozer, R, et al. (2013) Oncologists’ protocol and coping strategies in dealing with patient loss. Death Studies 37(10), 937–952. doi:10.1080/07481187.2012.692461.CrossRefGoogle ScholarPubMed
Houck, D (2014) Helping nurses cope with grief and compassion fatigue: An educational intervention. Clinical Journal of Oncology Nursing 18(4), 454–458. doi:10.1188/14.CJON.454-458.CrossRefGoogle ScholarPubMed
Hulkower, R (2010) The history of the Hippocratic Oath: Outdated, inauthentic, and yet still relevant. Albert Einstein College of Medicine 25(1), 41–44.10.23861/EJBM20102542CrossRefGoogle Scholar
Hutson, SP, Hall, JM and Pack, FL (2015) Survivor guilt: Analyzing the concept and its contexts. Advances in Nursing Science 38(1), 20–33. doi:10.1097/ANS.0000000000000058.CrossRefGoogle ScholarPubMed
Johansson, K and Lindahl, B (2012) Moving between rooms–moving between life and death: Nurses’ experiences of caring for terminally ill patients in hospitals. Journal of Clinical Nursing 21(13–14), 2034–2043. doi:10.1111/j.1365-2702.2011.03952.x.CrossRefGoogle ScholarPubMed
Kaba, R and Sooriakumaran, P (2007) The evolution of the doctor-patient relationship. International Journal of Surgery 5(1), 57–65. doi:10.1016/j.ijsu.2006.01.005.CrossRefGoogle ScholarPubMed
Kearney, MK, Weininger, RB, Vachon, MLS, et al. (2009) Self-care of physicians caring for patients at the end of life: “being connected. A key to my survival”. JAMA 301(11), 1155. doi:10.1001/jama.2009.352.CrossRefGoogle Scholar
Khoshnood, N, Hopwood, M-C, Lokuge, B, et al. (2018) Exploring Canadian physicians’ experiences providing medical assistance in dying: A qualitative study. Journal of Pain and Symptom Management 56(2), 222–229.e1. doi:10.1016/j.jpainsymman.2018.05.006.CrossRefGoogle ScholarPubMed
Kohlwes, RJ, Koepsell, TD, Rhodes, LA, et al. (2001) Physicians’ responses to patients’ requests for physician-assisted suicide. Archives of Internal Medicine 161(5), 657–663.10.1001/archinte.161.5.657CrossRefGoogle ScholarPubMed
Luxardo, N, Padros, CV and Tripodoro, V (2014) Palliative care staff perspectives: The challenges of end-of-life care on their professional practices and everyday lives. Journal of Hospice & Palliative Nursing 16(3), 165–172. doi:10.1097/NJH.0000000000000036.CrossRefGoogle Scholar
Miller, PJ, Mesler, MA and Eggman, ST (2002) Take some time to look inside their hearts: Hospice social workers contemplate physician assisted suicide. Social Work in Health Care 35(3), 53–64. doi:10.1300/J010v35n03_04.CrossRefGoogle ScholarPubMed
Miller, LL, Harvath, TA, Ganzini, L, et al. (2004) Attitudes and experiences of Oregon hospice nurses and social workers regarding assisted suicide. Palliative Medicine 18(8), 685–691. doi:10.1191/0269216304pm961oa.CrossRefGoogle ScholarPubMed
Minister of Justice (2016) An act to amend the criminal code and to make related amendments to other a (medical assistance in dying). Pub. L. No. C-14.Google Scholar
Mitchell, K (2004) Physician commitment in end of life care—Perspectives from New Zealand and the Netherlands. Social Science & Medicine 59(4), 775–785. doi:10.1016/j.socscimed.2003.11.026.CrossRefGoogle ScholarPubMed
Sanchez-Reilly, S, Morrison, LJ, Carey, E, et al. (2013) Caring for oneself to care for others: Physicians and their self-care. The Journal of Supportive Oncology 11(2), 75–81.10.12788/j.suponc.0003CrossRefGoogle ScholarPubMed
Sercu, M, Pype, P, Christiaens, T, et al. (2012) Are general practitioners prepared to end life on request in a country where euthanasia is legalised?: Table 1. Journal of Medical Ethics 38(5), 274–280. doi:10.1136/medethics-2011-100048.CrossRefGoogle Scholar
Shanafelt, TD, Raymond, M, Kosty, M, et al. (2014) Satisfaction with work-life balance and the career and retirement plans of US oncologists. Journal of Clinical Oncology 32(11), 1127–1135. doi:10.1200/JCO.2013.53.4560.CrossRefGoogle ScholarPubMed
Siden, H (2016) Physician stress in the context of medical aid in dying. UBCMJ 8(1), 7–8.Google Scholar
Smets, T, Cohen, J, Bilsen, J, et al. (2011) Attitudes and experiences of Belgian physicians regarding euthanasia practice and the euthanasia law. Journal of Pain and Symptom Management 41(3), 580–593. doi:10.1016/j.jpainsymman.2010.05.015.CrossRefGoogle ScholarPubMed
Vachon, M and Sherwood, C (2007) Staff stress and burnout. In Berger, A, Shuster, J & Von Roenn, J (eds.), Principles and Practice of Palliative Care and Supportive Oncology, 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins, pp. 667–686.Google Scholar
Vahey, DC, Aiken, LH, Sloane, DM, et al. (2004) Nurse burnout and patient satisfaction. Medical Care 42(Suppl), II-57–II-66. 10.1097/01.mlr.0000109126.50398.5a.10.1097/01.mlr.0000109126.50398.5aCrossRefGoogle ScholarPubMed
van Bruchem-van de Scheur, GG, van der Arend, AJG, Spreeuwenberg, C, et al. (2007) Euthanasia and physician-assisted suicide in the Dutch homecare sector: The role of the district nurse. Journal of Advanced Nursing 58(1), 44–52. doi:10.1111/j.1365-2648.2007.04224.x.CrossRefGoogle ScholarPubMed
Van Wesemael, Y, Cohen, J, Onwuteaka-Philipsen, BD, et al. (2009) Role and involvement of life end information forum physicians in euthanasia and other end-of-life care decisions in Flanders, Belgium. Health Services Research 44(6), 2180–2192. doi:10.1111/j.1475-6773.2009.01042.x.CrossRefGoogle ScholarPubMed
Voorhees, JR, Rietjens, JAC, van der Heide, A, et al. (2013) Discussing physician-assisted dying: Physicians’ experiences in the United States and the Netherlands. The Gerontologist 54(5), 808–817. doi:10.1093/geront/gnt087.CrossRefGoogle ScholarPubMed
Voorhees, JR, Rietjens, JAC, van der Heide, A, et al. (2014) Discussing physician-assisted dying: Physicians’ experiences in the United States and the Netherlands. The Gerontologist 54(5), 808–817. doi:10.1093/geront/gnt087.CrossRefGoogle ScholarPubMed
Wilson, J (2014) Ward staff experiences of patient death in an acute medical setting. Nursing Standard 28(37), 37–45. doi:10.7748/ns.28.37.37.e7949.CrossRefGoogle Scholar
Yoon, JD, Hunt, NB, Ravella, KC, et al. (2017) Physician burnout and the calling to care for the dying: A national survey. American Journal of Hospice and Palliative Medicine® 34(10), 931–937. doi:10.1177/1049909116661817.CrossRefGoogle ScholarPubMed