执业人员对2021年加拿大死亡医疗援助法修正案的经验:定性分析
Eliana Close1, Jocelyn Downie2, Ben P White3
1Australian Centre for Health Law Research, Faculty of Business and Law, Queensland University of Technology, GPO Box 2434, Brisbane, QLD 4001, Australia.
Palliative care and social practice
|December 27, 2023
概括
加拿大医疗保健提供者分享了根据C-7法案对死亡医疗援助 (MAiD) 法律变化的经验. 该研究发现,虽然修正案消除了障碍,但它们也引入了新的伦理挑战,并增加了从业人员的工作负担.
科学领域:
- 医疗法律和伦理学
- 医疗保健服务研究 医疗服务研究
- 卫生社会学 卫生社会学
背景情况:
- 2016年,加拿大在最高法院的卡特诉加拿大判决和C-14法案之后,将死亡医疗援助 (MAiD) 合法化.
- 五年后颁布的C-7法案大大修改了MAiD立法,特别是取消了"合理可预见的自然死亡"标准,并引入了最终同意豁免.
- 关于C-7法案修正案的实际实施和影响的研究有限.
研究的目的:
- 调查MAiD评估人员和提供者的经验,以了解C-7法案所引入的修正案.
- 探索这些经验对理解和改进监管改革和MAiD实施的影响.
- 识别在加拿大的MAiD不断变化的格局中导航的挑战和成功.
主要方法:
- 进行了定性主题分析.
- 与32名MAiD评估人员和提供者 (25名医生,7名执业护士) 进行了半结构化访谈.
- 参与者从不列颠哥伦比亚省 (n=10),安大略省 (n=15) 和新斯科舍省 (n=7) 招募.
主要成果:
- 出现了五个关键主题:消除MAiD访问障碍,导航监管和系统重新校准,识别工作负载负担,确定个人道德界限,并应对道德紧张局势.
- 实践者报告说,由于取消了"合理可预见的自然死亡"要求,并将精神障碍患者的MAiD视为唯一潜在的疾病,因此出现了导航复杂性.
- 该研究确定了C-7法案在解决以前的立法问题方面的预期积极影响以及引入的意想不到的复杂性.
结论:
- 这项研究提供了关于C-7法案对医生和执业护士的实际影响的早期见解.
- 立法变化虽然解决了先前的问题,但引入了新的复杂性,需要从业人员仔细导航.
- 有效的MAiD监管需要强有力的政府领导,组织间协调,并在立法改革期间积极参与医疗保健提供者.
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