Evidence map›Paper›PMID 40325437›Full record

ArticleBMC medical ethics2025

Health leaders' perspectives and attitudes on medical assistance in dying and its legalization: a qualitative study.

Amanda Yee, Eryn Tong, Rinat Nissim, Camilla Zimmermann, Sara Allin, Jennifer L Gibson, Madeline Li, Gary Rodin, Gilla K Shapiro

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Article in BMC medical ethics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Amanda YeeLeslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
Eryn TongDepartment of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Rinat NissimDepartment of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Camilla ZimmermannDepartment of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Sara AllinInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Jennifer L GibsonInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Madeline LiDepartment of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Gary RodinDepartment of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Gilla K ShapiroDepartment of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada. gilla.shapiro@uhn.ca.

Funding

Vanier Canada Graduate Scholarship 186866
6 · The paper itself

Abstract

backgroundMedical Assistance in Dying (MAiD) has transformed health policy and practice on death and dying. However, there has been limited research on what shaped its emergence in Canada and the beliefs and views of health leaders who hold positions of influence in the healthcare system and can guide policy and practice. The objective of this study was to examine health leaders' perspectives on the factors that led to the emergence of MAiD and explore their attitudes about the legalization of MAiD.

methodsIn this qualitative study, we conducted online semi-structured interviews with health leaders from April 2021 to January 2022. Purposive and snowball sampling techniques were used to recruit health leaders who have expertise and engagement with the delivery of MAiD or palliative and end-of-life care, and who hold positions of leadership relevant to MAiD in their respective organisations. Inductive thematic analysis was used to analyze the transcribed interviews.

resultsThirty-six health leaders were interviewed. Participants identified six factors that they believed to have led to the introduction of MAiD in Canada: public advocacy and influence; judicial system and notable MAiD legal cases; political ideology and landscape; policy diffusion; healthcare system emphasis on a patient-centred care approach; and changes in societal and cultural values. Participants expressed wide-ranging attitudes on the legalization of MAiD. Some described overall agreement with the introduction of MAiD, while still raising concerns regarding vulnerability. Others held neutral attitudes and indicated that their attitudes changed on a case-by-case basis. Participants described four factors that they considered to have had influence on their attitudes: personal illness experiences; professional experiences and identity; moral and religious beliefs; and, the valence of patient autonomy and quality of life.

conclusionsThis study highlights the wide-ranging and complex attitudes health leaders may hold towards MAiD and identifies the convergence of multiple factors that may have contributed to the legalization of MAiD in Canada. Understanding health leaders' attitudes and perspectives on the legalization of MAiD may inform stakeholders in other countries who are considering the legalization of assisted dying.

Indexed as

Attitude of Health PersonnelSuicide, AssistedAdultCanadaFemaleHealth PolicyHumansLeadershipMaleMiddle AgedPalliative CareQualitative ResearchTerminal CareAttitudesCanadaEnd-of-Life careHealth policyMedical assistance in dyingPerspectivesQualitative research

Identifiers

PMID40325437
PMCPMC12053847

What OpenQuestion holds

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LicenceCC BY
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.