Medical aid in dying: A foreseen decisive role for the specialized nurse practitioner in Quebec

Abstract

The legalisation of the practice of euthanasia is gaining momentum worldwide. This paper dresses the evolution of the legalisation and development of the practice of euthanasia – medical aid in dying (MAiD) – in Canada and especially in the province of Quebec to provide understanding and guidance for health care practitioners, administrators and a larger audience. This literature review explores the phenomenon of the increasing practice of MAiD in the province of Quebec (Canada) and its possible extension into practice by specialised nurse practitioners (SNPs), it also addresses the history and issues of the practice of MAiD in this context. The analysis made it possible to define three themes that make up this phenomenon, namely a) MAiD in Canada: Implementation of the Role of NPs; b) Growing demand for MAiD in Quebec’s province; c) Issues Related to a Possible Practice of MAiD by SPNs in Quebec. Results show the rising of MAiD practised in Canada and, in Quebec, especially for an aging population and those struggling with terminal illness in order to avoid undue prolongation of suffering at the end of life. However, access to end-of-life care (EoLC) and MAiD is undermined by a shortage of doctors, bureaucratic debacles, a lack of interdisciplinary cohesion and practice and, the geographical remoteness of patients. This study also highlights the modest field of research and investigation in this specific area of practice and the need for explicit teaching about the topic of the practice of MAiD for health professionals. Finally, results show that in order to remedy this problems, the governments of Canada and Quebec and various professional orders, namely those of nurses, physicians and pharmacists, have come together to promote access to MAiD by proposing a practice project for SNPs duly trained at Master degree.