Canadian neurosurgeons' views on medical assistance in dying (MAID): a cross-sectional survey of Canadian Neurosurgical Society (CNSS) members

J Med Ethics. 2019 May;45(5):309-313. doi: 10.1136/medethics-2018-105160. Epub 2019 Mar 12.

Abstract

Background: The Supreme Court of Canada removed the prohibition on physicians assisting in patients dying on 6 February 2015. Bill C-14, legalising medical assistance in dying (MAID) in Canada, was subsequently passed by the House of Commons and the Senate on 17 June 2016. As this remains a divisive issue for physicians, the Canadian Neurosurgical Society (CNSS) has recently published a position statement on MAID.

Methods: We conducted a cross-sectional survey to understand the views and perceptions among CNSS members regarding MAID to inform its position statement on the issue. Data was collected from May to June 2016.

Results: Of the 300 active membes of the CNSS who recevied the survey, 89 respondents completed the survey, 71% of whom were attending neurosurgeons and 29% were neurosurgery residents. Most respondents,74.2%, supported the right of physicians to participate in MAID with 7.8% opposing. 37% had current patients in their practice fitting the criteria for MAID. 23.6% had been asked by patients to assist with MAID, but only 11% would consider personally providing it. 84% of neurosurgeons surveyed supported the physicians' right to conscientious objection to MAID while 21% thought attending surgeons should be removed from the inquiry and decision-making process. 43.8% agreed that the requirment to refer a patient to a MAID service should be mandatory. Glioblastoma multiforme (65%), quadriplegia/quadriparesis secondary to spinal tumour/trauma (54%) and Parkinson's disease (24%) were the most common suggested potential indications for MAID among the neurosurgical population.

Conclusions: Our results demonstrate that most neurosurgeons in Canada are generally supportive of MAID in select patients. However, they also strongly support the physicians' right to conscientious objection.

Keywords: conscientious objection; end-of-life; euthanasia; neuroethics; suicide/assisted suicide.

MeSH terms

  • Attitude of Health Personnel
  • Canada
  • Clinical Decision-Making / ethics*
  • Cross-Sectional Studies
  • Humans
  • Neurosurgeons / ethics*
  • Neurosurgeons / legislation & jurisprudence
  • Personal Autonomy
  • Professional Role
  • Societies, Medical
  • Suicide, Assisted / ethics*
  • Suicide, Assisted / legislation & jurisprudence
  • Terminally Ill / legislation & jurisprudence*