You are here

Article Text

Article menu
Download PDFPDF
Original research
Public interest in medical assistance in dying and palliative care
  1. Emily YiQin Cheng1,
  2. Kenneth Mah1,
  3. Ahmed Al-Awamer1,2,3,
  4. Ashley Pope1,
  5. Nadia Swami1,
  6. Joanne L Wong1,
  7. Jean Mathews1,2,4,
  8. Doris Howell1,5,6,
  9. Breffni Hannon1,2,
  10. Gary Rodin1,6,7,
  11. Gilla K Shapiro1,
  12. Madeline Li1,7,
  13. Lisa W Le8 and
  14. Camilla Zimmermann1,2,6,7
  1. 1 Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
  2. 2 Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  3. 3 Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
  4. 4 Division of Palliative Medicine, Departments of Medicine and Oncology, Queen's University, Kingston, Ontario, Canada
  5. 5 Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
  6. 6 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  7. 7 Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
  8. 8 Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
  1. Correspondence to Dr Camilla Zimmermann, Department of Supportive Care, University Health Network, Toronto, ON M5G 2C4, Canada; camilla.zimmermann{at}uhn.ca

Abstract

Objectives Medical assistance in dying (MAiD) is legal in an increasing number of countries, but there are concerns that its availability may compromise access to palliative care. We assessed public interest in MAiD, palliative care, both, or neither, and examined characteristics associated with this interest.

Methods We surveyed a representative sample of the adult Canadian public, accessed through a panel from May to June 2019. Weighted generalised multinomial logistic regression analyses were used to determine characteristics associated with interest in referral to palliative care, MAiD, or both, in the event of diagnosis with a serious illness.

Results Of 1362 participants who had heard of palliative care, 611 (44.8% weighted (95% CI 42.1% to 47.5%)) would be interested in both MAiD and palliative care, 322 (23.9% (95% CI 21.5% to 26.2%)) palliative care alone, 171 (12.3% (95% CI 10.5% to 14.1%)) MAiD alone and 258 (19.0% (95% CI 16.9% to 21.2%)) neither. In weighted multinomial logistic regression analyses, interest in both MAiD and palliative care (compared with neither) was associated with better knowledge of the definition of palliative care, older age, female gender, higher education and less religiosity; interest in palliative care alone was associated with better knowledge of the definition of palliative care, older age, female gender and being married/common law; interest in MAiD alone was associated with less religiosity (all p<0.05).

Conclusions There is substantial public interest in potential referral to both MAiD and palliative care. Simultaneous availability of palliative care should be ensured in jurisdictions where MAiD is legal, and education about palliative care should be a public health priority.

  • Supportive care
  • Terminal care
  • Education and training

Data availability statement

Data are available upon request.

https://doi.org/10.1136/spcare-2022-003910

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    Data are available upon request.

    View Full Text

    Footnotes

    • Twitter @gary_rodin, @ZimmTeamLab

    • Contributors YQC contributed to data curation, writing of original draft and critical revision of manuscript. KM contributed to analysis and interpretation of data, writing of original draft and critical revision of manuscript. AA-A contributed to interpretation of the data, and critical revision of the manuscript. AP and NS contributed to conception and design, methodology, data curation, project administration and critical revision of manuscript. JW contributed to conception and design, collection of data and critical revision of manuscript. JM contributed to interpretation of the data and critical revision of the manuscript. DH, BH and GR contributed to conception and design, interpretation of the data, and critical revision of manuscript. GKS and ML contributed to interpretation of the data, and critical revision of manuscript. LL contributed to conception and design, methodology, formal statistical analysis and interpretation of the data, writing of the original draft, and critical revision of manuscript. CZ contributed to conception and design, methodology, obtaining funding, analysis and interpretation of data, writing of original draft and critical revision of manuscript.

    • Funding This research was funded by the Canadian Institutes of Health Research (grant number 152996; CZ), the Ontario Medical Association, and the Ontario Ministry of Health and Long-Term Care. CZ is supported by the Harold and Shirley Lederman Chair in Psychosocial Oncology and Palliative Care, a joint Chair among the University of Toronto, Princess Margaret Cancer Centre/University Health Network and the Princess Margaret Cancer Foundation.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.