Project 460701

Medical Assistance in Dying (MAiD) is legal in Canada since 2016. Many eligibility criteria are challenging to assess, especially unbearable suffering and providing informed consent (i.e., providing information on alternative options to relieve suffering, including palliative care). We conducted a scoping review aimed to better understand how the Canadian scientific literature (n=570) and clinical practice documents (n=537) approached the concept of suffering in definition, assessment and management within MAiD practice. Our analysis underlines a lack of structure around how suffering is defined, assessed, and addressed in MAiD; contrasting with the longstanding practice of palliative and end-of-life care, which offers a variety of evaluation tools and interventions to alleviate suffering in patients and families facing a chronic life-threatening medical condition. Our interdisciplinary team of medical, palliative and end-of-life, and MAiD researchers and clinicians, patients and family caregivers, government representatives and advocates from across Canada, plan to hold a 2-day Knowledge Dissemination and Research Planning Initiative on July 14-15, 2022, held virtually to: 1) disseminate results of our scoping review, and on this basis 2) discuss challenges in how MAiD eligibility criteria are currently defined and evaluated in clinical practice documents, with a focus on suffering and the process of offering alternatives as part of consent, including palliative care; 3) discuss improvements to clinical practice documents in definitions, eligibility evaluation, and offered alternatives based on embodied knowledge and evidence-based practices in the fields of palliative and end-of-life care; and 4) develop a research agenda on MAiD in Canada that focuses on suffering, in order to promote optimal end-of-life care. This initiative will lead to tangible improvements in clinical practice and research to optimize the care of people requesting MAiD in Canada.