Abstracts
Abstract
Context: In most jurisdictions where medical-aid-in-dying (MAiD) is available, this option is reserved for individuals suffering from incurable physical conditions. Currently, in Canada, people who have a mental illness are legally excluded from accessing MAiD. Methods: We developed a questionnaire for mental health care providers to better understand their perspectives related to ethical issues in relation to MAiD in the context of severe and persistent suffering caused by mental illness. We used a mixed-methods survey approach, using a concurrent embedded model with both closed and open-ended questions. Findings: 477 healthcare providers from the province of Québec (Canada) completed the questionnaire. One third of the sample (34.4%) were nurses, one quarter psychologists (24.3%) and one quarter psycho-educators (24%). Nearly half of the respondents (48.4%) considered that people with a severe mental illness should be granted the right to opt for MAiD as a way to end their suffering. Respondents were more likely to feel comfortable listening to the person and participating in discussions related to MAiD for a mental illness than offering care or the means for the person to access MAiD. Most (86.2%) reported that they had not received adequate/sufficient training, education or preparation in order to address ethical questions surrounding MAiD. Conclusions: The findings highlight how extending MAiD to people with a mental illness would affect daily practices for mental healthcare providers who work directly with people who may request MAiD. The survey results also reinforce the need for adequate training and professional education in this complex area of care.
Keywords:
- assisted suicide,
- medical-aid-in-dying,
- surveys and questionnaire,
- mental health,
- healthcare providers,
- ethics
Résumé
Contexte : Dans la plupart des juridictions où l’aide médicale à mourir (AMM) est disponible, cette option est réservée aux personnes souffrant d’affections physiques incurables. À l’heure actuelle, au Canada, les personnes atteintes d’une maladie mentale sont légalement exclues de l’AMM. Méthodes : Nous avons développé un questionnaire à l’intention des soignants en santé mentale afin de mieux comprendre leurs points de vue sur les questions éthiques liées à l’AMM dans le contexte de souffrances graves et persistantes causées par une maladie mentale. Nous avons employé une méthode mixte, utilisant un modèle intégré avec des questions fermées et ouvertes. Résultats : 477 soignants de la province du Québec (Canada) ont rempli le questionnaire. Un tiers de l’échantillon (34,4%) étaient des infirmières, un quart des psychologues (24,3%) et un quart des psychoéducateurs (24%). Près de la moitié des personnes interrogées (48,4%) ont estimé que les personnes atteintes d’une maladie mentale grave devraient avoir le droit d’opter pour l’AMM afin de mettre fin à leurs souffrances. Les répondants étaient plus susceptibles de se sentir à l’aise d’écouter la personne et de prendre part aux discussions sur l’AMM pour une maladie mentale que d’offrir des soins ou les moyens à la personne d’accéder à l’AMM. La plupart (86,2%) ont déclaré ne pas avoir reçu de formation, d’éducation ou de préparation adéquate/suffisante pour traiter les questions éthiques liées à l’AMM. Conclusions : Les résultats soulignent comment l’extension de l’AMM aux personnes atteintes de maladie mentale affecterait les pratiques quotidiennes des soignants en santé mentale travaillant directement avec des personnes susceptibles de demander l’AMM. Les résultats soulignent également les besoins de formation et d’éducation professionnelle adéquates dans ce domaine complexe de soins.
Mots-clés :
- suicide assisté,
- aide médicale à mourir,
- enquêtes et questionnaire,
- santé mentale,
- prestataires de soins de santé,
- éthique
Appendices
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