Research Centre on Aging, CIUSSS de l'Estrie - CHUS, Sherbrooke, Canada.
Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada.
J Soc Work End Life Palliat Care. 2022 Jul-Sep;18(3):273-292. doi: 10.1080/15524256.2022.2093314. Epub 2022 Jul 6.
Canada has legalized medical assistance in dying (MAID) for mentally competent persons who satisfy the legal requirements. Debate is ongoing as to whether MAID should be accessible to no-longer-competent persons through an advance request. We conducted an anonymous vignette-based survey among 367 social workers from Quebec to (1) elicit their attitudes toward MAID in the context of dementia; (2) assess their underlying values and beliefs; and (3) compare their attitudes to those of nurses ( = 291) and physicians ( = 136). Acceptability of MAID among social workers ranges from 42% in the case where the person depicted in the vignette was still competent to request MAID herself, to 92% in that where she was incompetent, had requested MAID in writing before losing capacity, showed signs of severe distress, and was close to death. Acceptability tends to be higher among social workers than among nurses and physicians. Forty-one per cent of social workers dread the prospect of participating in the MAID process for a person lacking decisional capacity. Nonetheless, 83% would agree to be involved. Should MAID become accessible to persons lacking decisional capacity, social workers willing to be involved will need to be educated and trained in participating in this emotionally-charged process.
加拿大已经将医疗辅助自杀（MAID）合法化，适用于符合法律要求的有行为能力的人。目前正在争论，是否应该通过预先请求，让不再有行为能力的人也能获得 MAID。我们对魁北克的 367 名社会工作者进行了一项匿名案例研究调查，以了解他们在痴呆症背景下对 MAID 的态度；评估他们的潜在价值观和信念；并将他们的态度与护士（ = 291）和医生（ = 136）进行比较。社会工作者对 MAID 的接受程度从案例中描述的人仍然有能力自己请求 MAID 的 42%到她没有能力、在丧失能力之前书面请求 MAID、表现出严重痛苦迹象且接近死亡的 92%不等。社会工作者的接受程度普遍高于护士和医生。41%的社会工作者害怕参与缺乏决策能力的人的 MAID 程序。尽管如此，仍有 83%的人表示同意参与。如果 MAID 让没有决策能力的人也能获得，那么愿意参与的社会工作者将需要接受参与这个情绪化过程的教育和培训。
