While Canada may have legalized medical assistance in dying in 2016, the moral challenges continue for primary caregivers, including nurse practitioners who can legally access eligibility and provide assisted deaths.
UBC Okanagan nursing professor Barb Pesut, who is also the Canada Research chair in health, ethics and diversity, has been researching ways to improve palliative care for diverse groups of people as well as ways to improve the quality of life for seniors living at home with advancing chronic illness.
More recently, she delved into a study into the policy, practice and ethical implications of Medical Assistance in Dying (MAiD) for nurses.
“The question that haunts me is whether nurses have been sufficiently prepared to make an informed choice about their decision to participate, or not, in MAiD,” said Pesut.
“There is a prevailing tendency to assume that what we make legal is de facto also right.”
In a MAiD death, individuals know the day and hour of their death and the procedure itself is highly medicalized with the help of nurse practitioners.
For example, once the day and hour of a patient’s death was set, nurses worked tirelessly to ensure that the patient had choices about what those final moments would look like. Where did they want it to happen, who did they want present, and what did they want to be doing in those final moments.
According to the study, there is a grey area regarding the eligibility criteria for an assisted death. This grey area is really the area of clinical judgment. The courts have recognized that many of the decisions related to the assessment of eligibility for MAiD are medical, not legal decisions.
This has the potential to lead to quite a bit of variability in determining who is eligible to choose for MAiD and who is not.
While MAiD’s eligibility hinges on being at end-of-life, there is actually no criteria in the that requires individuals to be at end-of-life in order to request an assisted death.
The study found that this was such a different death experience for nurses who were tasked with the patients’ care.
Some of those who were undergoing MAiD looked relatively well compared to those patients who they normally treated at end-of-life.
For more information, visit the UBCO website.