ArticleBMJ open2021
How is the medical assistance in dying (MAID) process carried out in Nova Scotia, Canada? A qualitative process model flowchart study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Why Canadian MAiD is Not a Medical Procedure.The Linacre quarterly · 2026Article
- Sustainability of medical assistance in dying provision: Provider perspectives.Palliative & supportive care · 2026Article
- Descriptions and Experiences with Medical Assistance in Dying Models Across Canada: A Mixed Methods Study.Healthcare (Basel, Switzerland) · 2026Article
- [Psychotherapists' role in requests for assisted suicide-an open question].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2026Review
- Final destination - pharmacists' perspectives on assisted suicide (the PAS-study): a cross-sectional convergent parallel mixed-methods study.Journal of pharmaceutical policy and practice · 2026Article
- Characterizing Interdisciplinary U.S. Hospice Clinician Presence During Patient Self-Administration of Medical Aid in Dying Medication.Journal of palliative medicine · 2026Article
- Developing robust systems for Track 2 MAID in Canada: A qualitative study.Palliative care and social practice · 2025Article
- Patients' and Caregivers' Suggestions for Improving Assisted Dying Regulation: A Qualitative Study in Australia and Canada.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Care considerations in medical assistance in dying for persons with mental illness as the sole underlying medical condition: a qualitative study of patient and family perspectives.BMC psychiatry · 2024Article
- Barriers to connecting with the voluntary assisted dying system in Victoria, Australia: A qualitative mixed method study.Health expectations : an international journal of public participation in health care and health policy · 2023Article
- Health care providers' ethical perspectives on waiver of final consent for Medical Assistance in Dying (MAiD): a qualitative study.BMC medical ethics · 2022Article
- Medical assistance in dying: A reflection tool for pharmacists.Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPCArticle
- Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe aims of this study are: (1) to create a flowchart process model of how medical assistance in dying (MAID) occurs in Nova Scotia (NS), Canada and (2) to detail how NS healthcare professionals are involved in each stage of MAID. The research questions are: how is the MAID process carried out and which professionals are involved at which points? and which roles and activities do professionals carry out during MAID?
designQualitative process model flowchart study with semistructured interviews.
settingPrimary and secondary care in NS, Canada.
participantsThirty-two interviewees self-selected to participate (12 physicians, 3 nurse practitioners (NP), 6 nurses, 6 pharmacists and 5 healthcare administrators and advocates). Participants were included if they conduct assessments, provide MAID, fill prescriptions, insert the intravenous lines, organise care and so on.
resultsThe flowchart process model details five stages of how MAID occurs in NS: (1) starting the MAID process, (2) MAID assessments, (3) MAID preparation (hospital in-patient, hospital outpatient, non-hospital), (4) day of MAID and (5) post-MAID (hospital in-patient and outpatient, non-hospital, after leaving setting). Nineteen points where the process could stop or be delayed were identified. MAID differs slightly by location and multiple professionals from different organisations are involved at different points. Some physicians and NP provide MAID for free as they cannot be reimbursed or find it too difficult to be reimbursed.
conclusionsOur study adds knowledge about the MAID activities and roles of NS professionals, which are not documented in the international literature. Clinicians and pharmacists spend significant additional time to participate, raising questions about MAID's sustainability and uncompensated costs. The process model flowchart identifies where MAID can stop or be delayed, signalling where resources, training and relationship-building may need to occur. Knowing where potential delays can occur can help clinicians, administrators and policymakers in other jurisdictions improve MAID.
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