Exploring the attitudes and opinions of key stakeholders on physician-assisted dying and palliative care in Canada: a qualitative study protocol


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BMJ Open. December 3, 2021; 11 (12): e055789. doi: 10.1136 / bmjopen-2021-055789.


INTRODUCTION: Canadians have had legal access to medical assistance in dying (MAID) since 2016. However, despite a significant overlap in populations seeking MAID and in need of palliative care (PA) services, policies and best practices regarding the optimal relationship between MAID and PA services are not well developed. Multiple models are possible, including the autonomous delivery of these services and formal or informal coordination, collaboration or integration. However, it is not clear which of these approaches is the most appropriate, feasible or acceptable in different Canadian health contexts in the context of the COVID-19 pandemic and in the post-pandemic period. The purpose of this qualitative study is to understand the attitudes and opinions of key stakeholders in government, the health care system, patient groups, and academia in Canada regarding the optimal relationship between MAID and CP services.

METHODS AND ANALYSIS: A qualitative and targeted sampling approach will elicit feedback from stakeholders of 25-30 participants through semi-structured interviews. Stakeholders with expertise and commitment to MAID or PD who hold leadership positions in their respective organizations across Canada will be invited to provide their perspective on the relationship between MAID and PD; capacity building needs; policy development opportunities; and the impact of the COVID-19 pandemic on the relationship between AMM and PC services. Transcripts will be analyzed using content analysis. A framework for integrated health services will be used to assess the impact of integrating services at multiple levels.

ETHICS AND DISSEMINATION: This study received ethical approval from the Research Ethics Board of the University Health Network (No. 19-5518; Toronto, Canada). All participants will be required to provide informed electronic consent prior to scheduling a qualitative interview and verbal consent prior to the start of the qualitative interview. The results of this study could inform health care policy, the delivery of MAID and CP, and improve understanding of the multi-level factors relevant to the delivery of these services. The results will be disseminated in conferences and peer-reviewed publications.

PMID: 34862301 | DOI: 10.1136 / bmjopen-2021-055789


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