This talk discusses the implications of the findings of a qualitative study of Canadian physician-providers of Medical Assistance in Dying (MAiD). Twenty-one physicians were interviewed in 2019 about their experiences as early-adopting providers. Participants universally endorsed a focus on providing patient-centered care. They varied in how they approached decision-making for patients applying for MAiD and how they viewed their role within the doctor-patient relationship.
One group of participants placed moral decision-making with the patient, indicating a limited role for the provider. They focused on guiding the competent patient through the statutory MAiD requirements to actualize patient autonomy. Some described their role as “conduits”. Group two had intermediate views. The third grouping of participants described their professional judgment as important to the moral calculus of approval for MAiD. Their role was like that of a train conductor in that they positioned themselves as responsible for wider patient interests as part of maintaining their own professional and moral integrity during MAiD.
Participants’ narratives indicate that decisions about MAiD assessments are strongly influenced by provider reasoning regarding the physician's role in MAiD assessment and provision. This divergence reflects unclear role expectations in the context of rapidly changing cultural expectations regarding MAiD.