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Tuesday, November 26, 2019

Nurses Wrestling With the Moral Uncertainties of MAiD

mano pierna dedo comida Produce cuidado horneando brazo participación de cerca cuerpo humano ayuda piel envejecimiento mayor enfermera mano a mano apoyo cuidando Envejecido hospicio personas de edad avanzada enfermería sentido Mano amiga Manos cariñosas Cuidado de ancianos mano viejaBarbara Pesut and Sally Thorne
Impact Ethics
Originally posted October 23, 2019

Have you tried to imagine what it is like to be the healthcare provider who provides medical assistance in dying (MAiD)? What would it feel like to go into a strange home, to greet a patient and family, to start an intravenous line, to deliver the medications that rapidly cause death, and then to bring some sort of closure before leaving? Although there has been a great deal of attention paid to the regulation of MAiD, and its accessibility to the Canadian population, we have heard relatively little about the moral experiences of the healthcare providers at the forefront of providing this service. That is surprising in light of the fact that all but 6 of the 6,749 MAiD deaths in Canada that occurred between December 10, 2015 and October 31, 2018 were administered by physicians or nurse practitioners.

In a recent study we interviewed 59 nurses from across Canada, who had diverse experiences with participating in, or choosing not to participate in, the MAiD process. Canada is the first country to allow nurse practitioners to act as both MAiD assessors and providers. Canadian registered nurses also play a key role in providing care to patients and families considering, planning for, or receiving MAiD. We learned a lot about the experiences of being involved in MAiD and about the type of wrestling with moral uncertainty that the involvement can entail. Nurses worked hard to make sense of this radical new end-of-life option. Making sense required some soul searching, some important conversations, and in some cases, encounters with the procedure itself.

Encounters with MAiD were inevitably deeply impactful. Some participants described an emotional overload that was unanticipated and didn’t necessarily fade over time. Others described a deep sense of compassion and purpose—a sense of beauty. Still others described an accumulating sense of distress, a rising tide that they didn’t necessarily know how to deal with. This was particularly true for those nurses who worked alone on multiple cases because they were the sole person willing to provide MAiD. Even those who had experienced MAiD only as observers described an emotional climate within the care environment that was far-reaching.

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