Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Clinical Science

Program

Family Medicine

Supervisor

Sibbald, Shannon L.

2nd Supervisor

Kim, George

Co-Supervisor

Abstract

Aims: Since decriminalization in 2016, medical assistance in dying (MAiD) has transformed the landscape of end-of-life care in Canada. This study explored the experiences of community family physicians who provide MAiD.

Methods: Using a qualitative study design and phenomenological approach, semi-structured interviews were conducted of twelve physician providers in Southwestern Ontario. The transcripts were coded and inductively analyzed for overarching themes.

Findings: At the individual level, providers felt a profound sense of purpose. At the local level, participants reflected on the practical challenges encountered. At the system level, participants described the critical role of organizational support structures and the effects of legislative changes.

Conclusions: The results contribute to a deeper understanding of the MAiD experience in Canada, fostering ongoing discourse in this complex and evolving field of healthcare. The findings also hold the potential to impact decisions concerning upcoming training initiatives, policy formulation and legislative efforts.

Summary for Lay Audience

Medical assistance in dying (MAiD) is relatively new in Canada. In addition to palliative care, it offers another option for patients to alleviate their suffering at the end of life. MAiD is a controversial, complex, and sensitive topic in healthcare. There have been many changes to its delivery since its decriminalization in 2016. MAiD is often carried out by community family doctors. This study aims to understand the perspectives and experiences of community physicians who are actively involved in the MAiD process.

By listening and appreciating the experiences of community family physicians, the barriers and challenges that exist in MAiD care can be better understood. Twelve community family doctors were interviewed using a semi-structured guide. The analysis of these interviews for key themes revealed the individual, local and system level factors that influenced the providers.

The study offers a unique look at one aspect of the MAiD experience and sheds light on current practices in Canada. This is important work as patients considering or accessing MAiD are in vulnerable positions, therefore it is crucial to reflect on present protocols to ensure ongoing compassionate care. The understanding of the community provider perspective can help improve overall MAiD implementation and ultimately, lead to better care for patients and families.

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