Movatterモバイル変換


[0]ホーム

URL:


Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
Thehttps:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

NIH NLM Logo
Log inShow account info
Access keysNCBI HomepageMyNCBI HomepageMain ContentMain Navigation
pubmed logo
Advanced Clipboard
User Guide

Full text links

HighWire full text link HighWire Free PMC article
Full text links

Actions

.2020 Jul 8;10(7):e036054.
doi: 10.1136/bmjopen-2019-036054.

Provision of medical assistance in dying: a scoping review

Affiliations

Provision of medical assistance in dying: a scoping review

Max Zworth et al. BMJ Open..

Abstract

Objectives: The purpose of this study is to map the characteristics of the existing medical literature describing the medications, settings, participants and outcomes of medical assistance in dying (MAID) in order to identify knowledge gaps and areas for future research.

Design: Scoping review.

Search strategy: We searched electronic databases (MEDLINE, EMBASE, PsychINFO, CINAHL and CENTRAL), clinical trial registries, conference abstracts and professional guidelines from jurisdictions where MAID is legal, up to February 2020. Eligible report types included technical summaries, institutional policies, practice surveys, practice guidelines and clinical studies that describe MAID provision in adults who have provided informed consent for MAID.

Results: 163 articles published between 1989 and 2020 met eligibility criteria. 75 studies described details for MAID administered by intravenous medications and 50 studies provided data on oral medications. In intravenous protocols, MAID was most commonly administered using a barbiturate (34/163) or propofol (22/163) followed by a neuromuscular blocker. Oral protocols most often used barbiturates alone (37/163) or in conjunction with an opioid medication (7/163) and often recommended using a prokinetic agent prior to lethal drug ingestion. Complications included prolonged duration of the dying process, difficulty in obtaining intravenous access and difficulty in swallowing oral agents. Most commonly, the role of physicians was prescribing (83/163) and administering medications (75/163). Nurses' roles included administering medications (17/163) and supporting the patient (16/163) or family (13/163). The role of families involved providing support to the patient (17/163) and bringing medications from the pharmacy for self-administration (4/163).

Conclusions: We identified several trends in MAID provision including common medications and doses for oral and parenteral administration, roles of healthcare professionals and families, and complications that may cause patient, family and provider distress. Future research should aim to identify the medications, dosages, and administration techniques and procedures that produce the most predictable outcomes and mitigate distress for those involved.

Keywords: adult intensive & critical care; medical ethics; palliative care; protocols & guidelines.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses study selection flowchart. Adapted from Moheret al. MAID, medical assistance in dying.
Figure 2
Figure 2
Sample protocols for MAID administration by intravenous medications, including medications and dose ranges encountered in the scoping review. MAID, medical assistance in dying.
Figure 3
Figure 3
Sample protocols for MAID administration via oral medications, including medications and dose ranges encountered in the scoping review. MAID, medical assistance in dying.
See this image and copyright information in PMC

References

    1. First Session of the Parliament of Canada Bill C-14: an act to amend the criminal code and to make related amendments to other acts (medical assistance in dying); 2016.
    1. Health Canada Fourth interim report on medical assistance in dying in Canada, 2019.
    1. Nicol J. Medical assistance in dying: the law in selected Jurisdictions outside Canada, 2019.
    1. Harty C, Chaput AJ, Trouton K, et al. . Oral medical assistance in dying (MAiD): informing practice to enhance utilization in Canada. Can J Anaesth 2019;66:1106–12. 10.1007/s12630-019-01389-6 - DOI - PubMed
    1. Hedberg K, New C. Oregon's death with dignity act: 20 years of experience to inform the debate. Ann Intern Med 2017;167:579. 10.7326/M17-2300 - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources

Full text links
HighWire full text link HighWire Free PMC article
Cite
Send To

NCBI Literature Resources

MeSHPMCBookshelfDisclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.


[8]ページ先頭

©2009-2025 Movatter.jp