Pesut Barbara, Thorne Sally, Chambaere Kenneth, Hall Margaret, Schiller Catharine J
University of British Columbia Okanagan, Kelowna, Canada.
University of British Columbia, Vancouver, Canada.
Glob Qual Nurs Res. 2024 Feb 29;11:23333936241228233. doi: 10.1177/23333936241228233. eCollection 2024 Jan-Dec.
Medical Assistance in Dying (MAID) legislation has evolved rapidly in Canada with significant impacts on nursing practice. The purpose of this paper is to describe evolving complexities in legislative context and practice standards that influence the experiences nurse practitioners and registered nurses have with MAID. Qualitative interviews were conducted with 25 registered nurses and 10 nurse practitioners from diverse contexts across Canada. Participants described their practices and considerations when discussing MAID as part of advance care planning; their use of, and challenges with, waivers of consent; their practice considerations in negotiating the complexities of clients for whom death is not reasonably foreseeable; and their moral wrestling with the inclusion of MAID for persons whose sole underlying medical condition is mental illness. Findings illustrate the moral complexities inherent in the evolving legislation and the importance of robust health and social care systems to the legal and ethical implementation of MAID in Canada.
加拿大的医疗协助死亡(MAID)立法发展迅速,对护理实践产生了重大影响。本文旨在描述立法背景和实践标准中不断演变的复杂性,这些复杂性影响着执业护士和注册护士在MAID方面的经历。对来自加拿大不同背景的25名注册护士和10名执业护士进行了定性访谈。参与者描述了在将MAID作为临终关怀计划一部分进行讨论时的做法和考虑因素;他们在使用同意豁免方面的情况和面临的挑战;在为死亡并非合理可预见的客户协商复杂情况时的实践考虑;以及他们对于将MAID纳入仅患有精神疾病的人群所进行的道德考量。研究结果表明了不断演变的立法中固有的道德复杂性,以及强大的健康和社会护理系统对于加拿大MAID合法和道德实施的重要性。