A sign of the changing times? Perceptions of Canadian psychologists on assisted death.

Abstract

In 2015, the Supreme Court of Canada ruled that all Canadians had the right to control their own end-of-life (Carter v Canada, 2015). The federal government, in response, began drafting legislation to regulate physician-assisted death (PAD) in Canada. Assisted death is an umbrella term for [a] death that requires an intentional act or omission [from] second (Downie, 2004, p. 6). PAD refers to form of assisted death where a physician knowingly and intentionally provides person with the knowledge and/or means required to end his or her life (Canadian Medical Association, 2014). Clear terminology is essential because different definitions, according to Downie (2004), serve as the bases for superficial arguments (p. 6).PAD provides challenges and opportunities for Canadian psychologists. Challenges include limited understanding of the perceptions and competency of psychologists surrounding assisted death. Further, limited training exists for psychologists to develop competency (Werth, Lewis, & Richmond, 2009). Opportunities for psychologists emerge from their experience in treating mental illness, common occurrence at end-of-life (Wilson, Curran, & McPherson, 2005), large contributions to end-of-life research (Galbraith & Dobson, 2000), and experience providing assessments of client competency (Niederjohn & Rogers, 2009). Like psychiatrists, who are grouped with physicians for the purposes of research (Emanuel, 2002), psychologists seem to be among the most qualified professionals to provide insight and practical knowledge to the current debate (Galbraith & Dobson, 2000). In the context of legalizing PAD, psychologists have already provided information to the Supreme Court regarding the psychology of assisted death (Canadian Psychological Association, 2015).This study examined the knowledge and perceptions, both personal and professional, of Canadian psychologists on assisted death. To inform the literature as well as provide further perspectives to the PAD debate, the researchers asked two questions. What are the personal and professional perceptions of Canadian psychologists on assisted death? To what extent do Canadian registered psychologists feel confident in their abilities and training for assessing the competency of individuals requesting assistance in dying?MethodParticipants (i.e., registered psychologists practicing in parts of Canada) responded to 32-question online survey that took 20 min to complete. The survey was available for period of 2 months and was accessible through R2P2 (Canadian Psychological Association, 2014), Facebook (2015), as well as through consenting psychological associations.The authors developed six-part survey to address the research questions; Sections III, V, and VI are relevant to the current article. The questions in Section III, based upon the work of Wilson et al. (2013), addressed studied psychologists' personal and professional perceptions toward two elements of PAD: letting die (i.e., the right to refuse life-saving medical treatment) and receiving medical assistance in dying. Participants could answer yes, I believe every competent adult should have this right, yes, but I believe it should be allowed only in certain cases or situations, or no, I do not believe anyone should have this right. In Section V, the questions assessed studied psychologist's beliefs on their own ability to assess the competence of terminally ill adults pursuing PAD. In Section VI, psychologists were presented with two vignettes, based on the work of Levy et al. (2013), that aimed to assess the participant's personal and professional perceptions of PAD under different conditions (e.g., cases of mental illness vs. terminal illness). In Sections V and VI, participants rated statements on five point scale from strongly agree to strongly disagree.ResultsA total of 97 individuals responded, with all but four having listed themselves as being registered psychologists practicing in Canada. …