Implementation of Medical Assistance in Dying: A Scoping Review of Health Care Providers' Perspectives
Open accessAbstract
Research aims With the growing interest in Medical Assistance in Dying (MAiD), understanding health care professionals' roles and experiences in handling requests is necessary to evaluate the quality, consistency, and efficacy of current practices. This scoping review sought to map the existing literature on health care providers' perspectives of their involvement in MAiD.Methods A scoping review was conducted to address the following: 1) What are the roles of diverse health care professionals in the provision of MAiD? and 2) What professional challenges arise when confronted with MAiD requests? A literature search in electronic databases and gray literature sources was performed. Articles were screened, and a thematic content analysis synthesized key findings.Results After evaluating 1715 citations and 148 full-text papers, 33 articles were included. Perspectives of nurses (n = 10), physicians (n = 7), mental health providers (n = 7), pharmacists (n = 4), social workers (n = 3), and medical examiners (n = 1) were explored. Professional roles included consulting/supporting patients and/or other staff members with requests, assessing eligibility, administering/dispensing the lethal drugs, providing aftercare to bereaved relatives, and regulatory oversight. Challenges included lack of clear guidelines/protocols, role ambiguity, evaluating capacity/consent, conscientious objection, and lack of interprofessional collaboration.Conclusion Evidence from various jurisdictions highlighted a need for clear guidelines and protocols that define each profession's role, scope of practice, and legal boundaries for MAiD. Comprehensive models of care that incorporate multidisciplinary teams alongside improved clinician education may be effective to support MAiD implementation. Little is known about health care providers' perspectives in handling requests, especially outside physician practice and nursing.
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These perspectives support and are supported by prior research calling for MAiD care coordination, inter-professional approaches, and attention to applicants' and families' emotional, social and spiritual needs.
“These perspectives support and are supported by prior research calling for MAiD care coordination, inter-professional approaches, and attention to applicants’ and families’ emotional, social and spiritual needs, among others [24, 25, 50–52].”
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- Authors
- Fujioka, J. K., Mirza, R. M., McDonald, P. L., & Klinger, C. A.
- Affiliations
- University of Toronto (CA)
- Corresponding author
- Fujioka, Jamie K.
- Venue
- Journal of Pain and Symptom Management
- Publisher
- Elsevier BV
- Published
- 2018-06
- Volume
- 55
- Issue
- 6
- Pages
- 1564-1576.e9
- ISSN
- 0885-3924 (ISSN-L)
- OpenAlex
- W2788010664
- Cited by
- 127
- References
- 48
- Citations by year
- 2026: 14 · 2025: 16 · 2024: 14 · 2023: 18 · 2022: 22 · 2021: 15 · 2020: 16 · 2019: 12
- FWCI
- 1.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain and Symptom Management (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- medical assistance in dying, healthcare providers' perspectives, professional roles, interprofessional collaboration, conscientious objection, scope of practice, regulatory oversight, clinician education, multidisciplinary care model
- MeSH terms
- Attitude to Death, Health Personnel, Humans, Suicide, Assisted, Professional Role
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