Perception of roles across the interprofessional team for delivery of medical assistance in dying

ABSTRACT

In 2016, Canada joined many jurisdictions worldwide in legalizing Medical Assistance in Dying (MAiD). Given the paucity of qualitative research regarding the involvement of interprofessional health care providers (HCPs) in MAiD, the goal of this study was to better understand how HCPs viewed their role(s). Semi-structured interviews were conducted with 3 pharmacists, 10 nurses, and 8 social workers at an academic hospital in Toronto. Thematic analysis generated six broad themes: 1) Practical/Technical Component, 2) Education, 3) Support, 4) “Part of the Job,” 5) “All of the Job,” and 6) Lack of Published Information. While nurses and social workers espoused many commonalities, nursing roles were more “in the moment,” whereas social workers viewed their roles as beginning earlier and extending after provision of MAiD. There was a spectrum of how participants perceived their role: pharmacists minimized the task of dispensing medications as an insignificant experience, nurses viewed involvement as consistent with their other professional duties (specifically non-MAiD deaths), and social workers described MAiD as a unique opportunity to employ the full gamut of their skills. The study highlights the importance of supporting HCPs through education and information at both regulatory and research levels, recognizing the key roles they play in MAiD.

KEYWORDS:

• Interprofessional health care professionals
• medical assistance in dying
• nurses
• pharmacists
• semi-structured interviews
• social workers

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

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Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Debbie Selby

Debbie Selby is a palliative care physician at Sunnybrook Health Sciences Center with background training in internal medicine. She works clinically in an inpatient palliative care unit setting and is actively involved in MAiD assessments and provisions. Research interests range through several topics relevant to palliative care as well as research related to MAiD.

Rachel Wortzman

Rachel Wortzman is a palliative care physician at Sunnybrook Health Sciences Centre and assistant professor in the Department of Family & Community Medicine at the University of Toronto. She previously earned a Master of Public Health degree with a focus on health promotion and social determinants of health at the University of Toronto.

Sally Bean

Sally Bean is the Director of the Health Ethics Alliance & Policy at Sunnybrook Health Sciences Centre, a member of the University of Toronto Joint Centre for Bioethics, an Adjunct Lecturer in the Dalla Lana School of Public Health and the Institute of Health Policy Management and Evaluation, and an Associate Member of the School of Graduate Studies at the University of Toronto.

Anneliese Mills

Anneliese Mills is a Family Medicine resident at the University of Toronto, primarily based at the Sunnybrook Academic Family Health Team. She is a graduate of the Temerty Faculty of Medicine and she also holds a Bachelor's degree in History and Sociocultural Anthropology and a Master's degree in Medical Anthropology.