Favron-Godbout Caroline, Foster Izadora, Racine Eric
Pragmatic Health Ethics Research Unit, Montreal Clinical Research Institute, 110 av. des Pins O, Montreal, Quebec H2W 1R7, Canada; Université de Montréal, 2900 Bd Édouard-Montpetit, Montreal, Quebec, H3T 1J4, Canada.
Pragmatic Health Ethics Research Unit, Montreal Clinical Research Institute, 110 av. des Pins O, Montreal, Quebec H2W 1R7, Canada.
Int J Law Psychiatry. 2025 Sep-Oct;102:102114. doi: 10.1016/j.ijlp.2025.102114. Epub 2025 Jun 23.
The possibility of asking for help in ending one's life is at the heart of some of the most enduring debates in medicine and bioethics. As a growing number of countries open to the practice, many concerns are emerging internationally about medical assistance in dying where a mental disorder is the sole underlying medical condition (MAiD-MD). It is paramount to understand what academic literature and resources are available to support different stakeholders in the context of MAiD-MD.
This review aims to specifically identify various resources related to MAiD-MD and to initiate a process of compiling international resources to raise awareness about certain resources and support stakeholders to develop new resources.
This review of resources adopted a methodology inspired by the work of Arksey and O'Malley (2005) and Levac et al. (2010)'s scoping studies, as well as more structured forms of thematic literature reviews for content extraction.
165 resources related directly or indirectly to MAiD-MD were identified and grouped according to the following six categories: 1) Laws, judgments, decisions, and reports from the operationalization of laws; 2) Ethical and clinical guidelines, protocols, practice guides, and information for healthcare professionals; 3) Resource directories; 4) Resources for sharing experiences, discussions, support or training; 5) Written resources for MAiD applicants, their relatives or the population; 6) Resources to support reflections and guide the development of practices. Twenty main relevant themes were identified through the thematic analysis. These themes are addressed and explored in varying degrees of depth throughout different resources.
A diversity of relevant resources is developed internationally, but these are sometimes dispersed, little known, or inaccessible to the public. Numerous resources are developed to inform the various stakeholders and train healthcare professionals, but there seems to be a need to develop advanced support resources to help the various stakeholders in the context of MAiD-MD.
请求协助结束生命的可能性是医学和生物伦理学中一些最持久辩论的核心。随着越来越多的国家对这种做法持开放态度,国际上对仅以精神障碍作为潜在医疗状况的临终医疗协助(MAiD-MD)出现了许多担忧。了解有哪些学术文献和资源可在MAiD-MD背景下支持不同利益相关者至关重要。
本综述旨在具体识别与MAiD-MD相关的各种资源,并启动一个编纂国际资源的过程,以提高对某些资源的认识,并支持利益相关者开发新资源。
本资源综述采用了受阿克西和奥马利(2005年)以及莱瓦克等人(2010年)的范围界定研究所启发的方法,以及更结构化的主题文献综述形式进行内容提取。
共识别出165种与MAiD-MD直接或间接相关的资源,并根据以下六个类别进行了分组:1)法律、判决、决定以及法律实施的报告;2)针对医疗保健专业人员的伦理和临床指南、方案、实践指南及信息;3)资源目录;4)用于分享经验、讨论、支持或培训的资源;5)为MAiD申请者、其亲属或公众提供的书面资源;6)支持思考并指导实践发展的资源。通过主题分析确定了20个主要相关主题。在不同资源中,这些主题得到了不同程度的深入探讨。
国际上开发了各种各样的相关资源,但这些资源有时分散、鲜为人知或公众无法获取。开发了大量资源以告知各利益相关者并培训医疗保健专业人员,但在MAiD-MD背景下,似乎需要开发更高级的支持资源来帮助各利益相关者。