Medical Assistance in Dying in Quebec: A Continuum Between Teams' Accountability and Interdisciplinary Support Groups' Assumption of Responsibility

Catherine Perron; Eric Racine; Marie-Eve Bouthillier

doi:10.3389/ijph.2024.1607407

Medical Assistance in Dying in Quebec: A Continuum Between Teams' Accountability and Interdisciplinary Support Groups' Assumption of Responsibility

Int J Public Health. 2024 Aug 29:69:1607407. doi: 10.3389/ijph.2024.1607407. eCollection 2024.

Authors

Catherine Perron^{1

2}, Eric Racine^{3

4}, Marie-Eve Bouthillier^{1

2}

Affiliations

¹ Centre Integre de Sante et de Services Sociaux de Laval, Laval, QC, Canada.
² Department of Medicine, Montreal University, Montreal, QC, Canada.
³ Montreal Clinical Research Institute (IRCM), Montréal, QC, Canada.
⁴ Department of Medicine, McGill University, Montreal, QC, Canada.

Abstract

Objectives: In the province of Quebec, Canada, interdisciplinary support groups (ISGs) are mandated to support those who are involved in the clinical, administrative, legal and ethical aspects of medical assistance in dying (MAiD). This article presents the results of a mixed-method, multi-phase study carried out in 2021 on ISGs with the aim to describe current ISG practices, critically analyze them and make recommendations on promising practices for provincial implementation.

Method: Semi-structured interviews (42) and focus groups (7) with coordinators of 24 ISGs were used to identify promising practices and confirm their utility with participants.

Results: We have distributed the ISGs along what we coined an "ISG continuum." Between teams' accountability (decentralization) and ISGs' assumption of responsibility for MAiD requests (centralization), a middle ground approach, focused on the value of support, should be favored.

Conclusion: The structuring of ISGs and their practices is intimately linked to their values. Harmonization of ISGs and their practices, while considering their specific values and contexts, can contribute to the equity and quality of services intended for those who request MAiD and those who support them.

Keywords: coordination; medical assistance in dying; pragmatic ethics; support structures; values.

MeSH terms

Focus Groups
Humans
Interviews as Topic
Patient Care Team* / ethics
Qualitative Research
Quebec
Self-Help Groups* / ethics
Social Responsibility*
Stakeholder Participation
Suicide, Assisted* / ethics
Suicide, Assisted* / psychology
Suicide, Assisted* / statistics & numerical data
Suicide, Assisted* / trends

Grants and funding

The authors declare that financial support was received for the research, authorship, and/or publication of this article. This research was funded by the Ministry of Health and Social Services of Quebec (research grant MP-35-2021-659), the Research Institutes of Canada (EG4 179448), the University of Montreal (scholarship) and the Canadian Association of MAiD Assessors and Providers (research grant).