Grant: Project Grant

Changes in legislation about medical end-of-life practices have been recently adopted and will take effect soon. In addition to withdrawing life-sustaining treatments and using drugs to control symptoms such as severe pain, physicians are or will soon be authorized to administer lethal drugs upon voluntary request of end-of-life patients (Quebec) or for competent adults with grievous and irremediable medical condition (other provinces). To date, we do not have much information on end-of-life practices in Canada. The study hopes to collect the first baseline national data on how physicians treat patients at the end-of-life. Our objectives will include: (1) to document the frequency of different end-of-life practices (withholding and withdrawing life-sustaining treatments, using drugs to control symptoms, the intentional use of lethal drugs); (2) to describe how decision are made for end-of-life patients, and related ethical challenges; (3) to identify different characteristics (patient and physician) and decision-making approaches associated with the different types of end-of-life practices. Studies are needed to further our understanding of how decisions are made before death, to identify potential areas of improvement and training needs, to study the effect of policy changes, and to monitor developments in end-of-life practices over time.