Objectives The modern hospice movement has historically opposed assisted dying. The 2016 legalisation of medical assistance in dying (MAID) in Canada has created a new reality for Canadian hospices. There have been few studies examining how the legalisation of MAID has affected Canadian hospices. Our objective was to identify the challenges and opportunities hospice workers think MAID brings to a hospice.
Methods This qualitative descriptive study included four focus groups and four semistructured interviews with Canadian hospice workers at two hospices, one which allowed MAID on site, and one which did not. Thematic analysis was used to understand and report these challenges and opportunities.
Results We constructed five themes. These themes detailed participants’ beliefs in the abilities of hospice care, and how they felt MAID challenged these abilities. Further, participants felt that MAID itself created challenging situations for patients and families, and that local policies and practices led to additional institutional challenges. Some participants also felt that allowing MAID in hospice provided opportunities for more extensive end-of-life options.
Conclusions The legalisation of MAID in Canada has created both challenges and opportunities for Canadian hospices. A balancing of these challenges and opportunities may provide a path for Canadian hospices to navigate their new reality. Increasing demand for MAID means that hospices are likely to continue to encounter requests for MAID, and should enact supports to ensure staff are able to manage these challenges and make best use of the opportunities.
- hospice care
Data availability statement
Data are available on reasonable request. Reasonable requests for study data should be directed to the corresponding author, or to the Institutional Review Board at McGill University’s Faculty of Medicine (514-398-8302).
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Contributors This manuscript was developed from the MSc (Bioethics) thesis of JM, supervised by MEM. JM designed the design, generated the data, led the data analysis and completed the first draft of the manuscript. MEM supervised the study design and process, contributed both substantively and editorially to the manuscript. JM is the guarantor of this submission.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests JEM declares a competing interest as he has volunteered at one of the hospice sites.
Provenance and peer review Not commissioned; externally peer reviewed.
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