Perceptions and intentions toward medical assistance in dying among Canadian medical students

James Falconer,Félix Couture,Zachary Shefman,Michael Lang,Koray K Demir,Mark Woo

doi:10.1186/s12910-019-0356-z

Abstract

BackgroundMedical assistance in dying (MAID) was legalized in Canada in 2016. As of July 2017, approximately 2149 patients have accessed MAID. There remains no national-level data on the perspectives of future physicians about MAID or its changing legal status. We provide evidence from a national survey of Canadian medical students about their opinions, intentions, and concerns about MAID.MethodsFrom October 2016 to July 2017, we distributed an anonymous online survey to all students at 15 of Canada’s 17 medical schools. The survey collected data on respondent socio-demographic characteristics, features of their medical education, intentions for medical practice, and perspectives on MAID. We analyzed responses using univariate descriptive and stepwise multivariate logistic regression.ResultsIn 1210 completed surveys, 71% of respondents reported being willing to provide MAID under a legal framework that permits it. Non-religious respondents reported greater willingness to participate in MAID than respondents of any religious affiliation (p < 0.001). Frequency of religious attendance was inversely associated with willingness to provide MAID (p < 0.001). Medical students born in Québec were more willing to provide MAID than respondents from other provinces (OR 2.21; p < 0.001). Age, sex, socioeconomic status, year of medical study, previous academic major, and rural/urban city of birth were not associated with willingness to provide MAID.ConclusionAs the current class of medical students becomes the first cohort of new physicians to enter Canada’s changing medical and legal landscape around MAID, our findings inform the public debate by examining attributes associated with support or opposition to the practice.

Highlights

Medical assistance in dying (MAID) was legalized in Canada in 2016
Amid much public debate, medical assistance in dying (MAID) was legalized in Canada in 2016
As the cohort of Canadian physicians prepares to enter medical practice under a changing legal landscape, more research is needed to investigate whether Bill C-14 adequately responds to the needs and concerns of patients and physicians in the clinical setting

Summary

Introduction

Medical assistance in dying (MAID) was legalized in Canada in 2016. There remains no national-level data on the perspectives of future physicians about MAID or its changing legal status. We provide evidence from a national survey of Canadian medical students about their opinions, intentions, and concerns about MAID. Several countries have legalized medical assistance in dying (MAID), known as “physician-assisted dying” or “physician-assisted suicide,” over the past two decades. A 1993 Supreme Court of Canada ruling in the case of Rodriguez v. Due to gradual changes in public opinion on the issue, public discourse and activism culminated in the landmark 2015 Supreme Court case Carter v. Plaintiffs affected by degenerative and terminal diseases successfully argued that restricting assisted suicide either inhumanely prolonged their intolerable suffering, or forced them to end their lives while still physically capable of doing so themselves, depriving them of quality years of life

Objectives

Methods

Results

Discussion

Conclusion