Patient experiences with requests for medical assistance in dying: Perspectives of those with complex chronic conditions.

Objective: To explore experiences of patients who have complex chronic conditions (CCCs), such as fibromyalgia and chronic fatigue syndrome, when they request medical assistance in dying (MAID) in Canada.

Design: Qualitative study using semistructured interviews.

Setting: Canada.

Medical assistance in dying when natural death is not reasonably foreseeable: Survey of providers' experiences with patients making track 2 requests.

Objective: To describe clinicians' experiences with assessing patients making track 2 requests for medical assistance in dying (MAID) and providing MAID to such patients in the first 6 months after Canada amended relevant legislation in March 2021 to expand access to MAID.

Design: Online survey with closed and open-ended questions about clinicians' experiences with individual patients making track 2 MAID requests.

Setting: Canada.

Should Palliative Care Teams be Involved in Medical Assisted Dying?

Palliative care teams offer holistic care for patients experiencing serious illness and related suffering, nevertheless, there are times when clinicians are asked by patients for help to obtain assisted dying. Patients in a growing number of areas may be eligible to request medically administered or self-administered lethal medications to control the timing of death and palliative care practices, established to neither hasten nor postpone death, may be challenged when caring for patients asking for assisted dying. In this "Controversies in Palliative Care" article, we invite three experts to provide a synopsis of the key studies that inform their thought processes, share practical advice on their clinical approach, and highlight the opportunities for future research.

Are unmet needs driving requests for Medical Assistance in Dying (MAiD)? A qualitative study of Canadian MAiD providers.

In this study, 20 medical assistance in dying (MAiD) providers were interviewed about their experience when assessing patients with unmet needs, including medical, financial or social needs. Collectively they had experience with over 3700 MAiD assessments and found that unmet needs were rare. In the cases where patients had unmet needs, these were usually related to loneliness and poverty.

Medications and dosages used in medical assistance in dying: a cross-sectional study.

Background: There is little evidence describing the technical aspects of medical assistance in dying (MAiD) in Canada, such as medications, dosages and complications. Our objective was to describe clinical practice in providing MAiD in Ontario and Vancouver, Canada, and explore relations between medications used, time until death and complications.

Methods: We conducted a retrospective cohort study of a sample of adult (age ≥ 18 yr) patients who received MAiD in Ontario between 2016 and 2018, and patients who received MAiD in 1 of 3 Canadian academic hospitals (in Hamilton and Ottawa, Ontario, and Vancouver, British Colombia) between 2019 and 2020.

Self-Treatment of Chronic Low Back Pain Based on a Rapid and Objective Sacroiliac Asymmetry Test: A Pilot Study.

Background: Low back pain (LBP) is common, costly, and disabling. This study assesses a novel and simple LBP evaluation method and its merit in guiding the direction of a self-treatment exercise.

Methods: Randomized open-label intention is used to treat the study.

How can we improve the experiences of patients and families who request medical assistance in dying? A multi-centre qualitative study.

Background: Medical assistance in dying has been available in Canada for 5 years, but it is unclear which practices contribute to high-quality care. We aimed to describe patient and family perspectives of quality of care for medical assistance in dying.

Methods: We conducted a multi-centre, qualitative descriptive study, including face to face or virtual one-hour interviews using a semi-structured guide.

How the experience of medical assistance in dying changed during the COVID-19 pandemic in Canada: a qualitative study of providers.

Background: In March 2020, all levels of government introduced various strategies to reduce the impact of the COVID-19 pandemic. The purpose of this study was to document how the experience of providing medical assistance in dying (MAiD) changed during the COVID-19 pandemic.

Methods: We conducted a qualitative study using semistructured interviews with key informants in Canada who provided or coordinated MAiD before and during the COVID-19 pandemic.

Assessment of capacity to give informed consent for medical assistance in dying: a qualitative study of clinicians' experience.

Background: Under the Canadian , medical assistance in dying (MAiD) requires that patients give informed consent and that their ability to consent is assessed by 2 clinicians. In this study, we intended to understand how Canadian clinicians assessed capacity in people requesting MAiD.

Methods: This qualitative study used interviews conducted between August 2019 and February 2020, by phone, video and email, to explore how clinicians assessed capacity in people requesting MAiD, what challenges they had encountered and what tools they used.

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

The purpose of this study was to describe the experience of people who transferred locations for MAiD. It used mixed methods with a chart review from one health authority and interviews with key informants across Canada. In the chart review, we found that of 444 MAiD deaths, 42 (9.

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.

Drawing on interviews we conducted with 15 medical assistance in dying (MAiD) providers from across Canada, we examine how physicians and nurse practitioners reconcile respect for the new, changing rules brought upon by the coronavirus disease 2019 (COVID-19) pandemic, along with their existing legal obligations and ethical commitments as health care professionals and MAiD providers. Our respondents reported situations where they did not follow or did not insist on others following the applicable public health rules. We identify a variety of techniques that they deployed either to minimize, rationalize, justify or excuse deviations from the relevant public health rules.

How We Can Improve the Quality of Care for Patients Requesting Medical Assistance in Dying: A Qualitative Study of Health Care Providers.

Context: Since Canada decriminalized medical assistance in dying (MAID) in 2015, clinicians and organizations have developed policies and protocols to implement assisted dying in clinical practice. Five years on, there is little consensus as to what constitutes high-quality care in MAID.

Objectives: To describe MAID clinicians' perspectives on quality of care in MAID, including challenges, successes, and clinical practice suggestions.

Medical assistance in dying (MAiD) in Canada: practical aspects for healthcare teams.

In this paper we document some of the practical aspects of implementing medical assistance in dying (MAiD) since it became legal in Canada in 2016. The percentage of annual deaths in Canada due to MAiD varies widely, ranging from less than 0.5% in some areas to over 5% in others.

Comparing telemedicine to in-clinic medication abortions induced with mifepristone and misoprostol.

Objective: The objective was to compare the practical aspects of providing medication abortions through telemedicine and in-person clinic visits so that clinics can use this information when planning to add this service.

Study Design: We conducted a comparative retrospective chart review comparing telemedicine medication abortions to a control group matched for date seen. We extracted and compared demographics, use of dating ultrasound, outcomes and unscheduled visits or communications with staff and physicians.

The experience of volunteer witnesses for Medical Assistance in Dying (MAiD) requests.

Many jurisdictions with legal forms of assisted dying require that written requests be witnessed by independent witnesses. In Canada, a unique program of volunteers was founded to make such witnesses available. A total of 106 volunteers completed a questionnaire about their experiences, challenges, and perspectives; 24 were also interviewed.

Quality of care with telemedicine for medical assistance in dying eligibility assessments: a mixed-methods study.

Background: To facilitate access to medical assistance in dying (MAiD) in British Columbia, telemedicine has been used for eligibility assessments. This research explored the impacts of using telemedicine on quality of care.

Methods: This mixed-methods study consisted of data from 3 BC health authorities and semistructured interviews with a patient, support persons, providers and administrators about the use of telemedicine for MAiD eligibility assessment.

Perceptions and Experiences of Medical Assistance in Dying Among Illicit Substance Users and People Living in Poverty.

Since medical assistance in dying (MAiD) became legal in Canada in 2016, there have been concerns about vulnerable people feeling pressured to end their lives. It is important to understand what people in marginalized communities know and feel about MAiD in order to help prevent any pressure to hasten death and to prevent any barriers to accessing assisted death. This qualitative study explored the perceptions and experiences of MAiD and other end-of-life care options with 46 people who were illicit substance users, living in poverty, or who worked with marginalized people in these communities.

How Cannabis Alters Sexual Experience: A Survey of Men and Women.

Introduction: Cannabis is reported to enhance sexual function; yet, previous studies have shown that physiological and subjective indices of sexual arousal and motivation were associated with decreased availability of circulating endocannabinoid concentrations.

Aim: To explain this contradiction, we evaluated which aspects of sexual experience were enhanced or diminished by cannabis use.

Methods: We used an online questionnaire with a convenience sample of people who had experience with cannabis.

Providing medical assistance in dying: Practice perspectives.

Objective: To explore the experiences of the first cohort of physicians to offer medical assistance in dying (MAID) in British Columbia.

Design: Qualitative study using semistructured, one-on-one interviews.

Setting: British Columbia.

Exploring the experience of supporting a loved one through a medically assisted death in Canada.

Objective: To explore the experience of family and close friends of patients seeking medical assistance in dying (MAID) in Canada.

Design: Qualitative study using semistructured interviews.

Setting: A clinic in Vancouver, BC, that provides MAID services.

Experiences and perspectives of people who pursued medical assistance in dying: Qualitative study in Vancouver, BC.

Objective: To explore the experiences, wishes, fears, and beliefs of people who requested and were eligible for medical assistance in dying (MAID) in Canada in the first year after legalization.

Design: Qualitative study using semistructured interviews.

Setting: A clinic in Vancouver, BC, that provides MAID.

Reasons for requesting medical assistance in dying.

Objective: To review the charts of people who requested medical assistance in dying (MAID) to examine their reasons for the request.

Design: Retrospective chart survey.

Setting: British Columbia.