Canadian practitioners’ experiences with Bill C-7 amendments to medical assistance in dying laws: a qualitative analysis
Eliana Close1, Australian Centre For Health Law Research – QUT Brisbane 1Australian Centre For Health Law Research – QUT, Brisbane, QLD, Australia
Abstract
Background: Five years after Canada legalised medical assistance in dying (MAiD), Bill C-7 was passed which enacted several significant amendments. These included removing the ‘natural death is reasonably foreseeable’ eligibility criterion, creating two tracks of safeguards, and permitting a waiver of final consent in some circumstances. These changes have involved significant debate and media attention, yet very little research to date has examined their implementation.
Methods: This presentation reports on semi-structured interviews conducted with 32 MAiD assessors and providers across Canada (25 doctors, 7 nurse practitioners) on their experience with Bill C-7. Data were analysed using reflexive thematic analysis.
Results: Participants perceived Bill C-7 removed key barriers in practice to MAiD (such as overly stringent witnessing requirements) which were problems under the original legislation. However, it also introduced practical and ethical challenges. Practitioners described grappling with the extent to which they would be involved in cases in which patients did not have a reasonably foreseeable natural death.
Implications and dissemination: This research provides insights for countries which have MAiD laws or which are considering passing them. Canada used an evidence-based approach to remove unintended barriers to MAiD in practice. However, this research highlights the need to engage practitioners in advance of legislative changes, and to ensure regulatory and systems recalibration (such as the dissemination of practice standards and guidelines) occurs before legislation comes into force.
Authors: Dr Eliana Close (presenting); Professor Jocelyn Downie; Professor Ben White
Biography
Dr Eliana Close specialises in end-of-life law, policy, and practice. Eliana is leading a Canadian case study for Professor Ben White’s ARC Future Fellowship Project, Optimal Regulation of Voluntary Assisted Dying (2020-2024). She was a key contributor to voluntary assisted dying training programs in Victoria, Western Australia, and Queensland.