Choice and Death: Analysis of Medical Assistance in Dying for Head and Neck Cancer in Ontario

There is a paucity of information on the uptake of Medical Assistance in Dying (MAiD) for patients with head and neck cancer (HNC). Our study reports the prevalence, disease characteristics, and nature of the desire for MAiD in patients with HNC who underwent the process in Ontario. The aim is to better understand this population and identify gaps in our current system of care.

This is a retrospective cross-sectional analysis for the period June 17, 2016 to December 31, 2022. Data were received from the Office of the Chief Coroner Ontario, Canada.

Three hundred and fifty-six persons received MAiD. The average age was 72.4 years (SD 12.22) with 260 of the patients being men (73.03%). The most common HNC primary tumor site was the oral cavity 109 (30.6%). The most reported reason was inadequate control of symptoms other than pain (79.21%) followed by inadequate pain control or concerns about it (75%). The patient's private residence (55.62%) was the most common setting. Patients were more likely to live in wealthier neighborhoods and in large urban centers. Future prediction of MAiD uptake shows a linear year-by-year increase.

The use of MAiD in HNC has been steadily increasing since its legalization and is projected to continue increasing. There is a male predominance that is aligned with the incidence and prevalence of HNC nationally. Overall, MAiD is an increasingly employed choice for HNC patients receiving treatment for disease without curative intent.