Canada's Evolving Medicare: End-of-Life Care

Area of Science:

• Healthcare Policy
• Medical Ethics
• Public Health

Background:

• Canadian Medicare grapples with evolving end-of-life care, particularly after medical assistance in dying (MAiD) legalization.
• Stakeholder perspectives on end-of-life care components, including MAiD, are crucial for policy development.

Purpose of the Study:

• To compare public, health professional, and administrator support and priorities for end-of-life care options before and after MAiD legalization in Canada.
• To assess changes in stakeholder perceptions and fears related to MAiD implementation.

Main Methods:

• Analysis of data from the 2016 and 2018 Health Care in Canada (HCIC) surveys.
• Comparison of responses from adult public (n=1500), health professionals (n=400), and administrators (n=100) on end-of-life care priorities.

Main Results:

• All stakeholders strongly supported enhanced end-of-life care options, including MAiD.
• In 2018, the public prioritized MAiD, while health professionals prioritized hospice/palliative care.
• Health professionals and administrators reported increased fear of reprisal regarding MAiD, despite system supports being perceived as adequate by administrators.

Conclusions:

• Optimal end-of-life care management requires addressing varied stakeholder priorities and increasing professional fears surrounding MAiD.
• Continued monitoring of implemented end-of-life treatments and system supports, especially for MAiD, is essential for future care improvements.