Grant: Project Grant

Suffering at end-of-life is not new or uncommon. However, what is new in Canada are the options available to address this suffering and how those options are intersecting in end-of-life decision-making. In this grant, we are using the acronym STRS-EOL to refer to these options for relieving suffering at end-of-life and they include medical assistance in dying (MAiD), palliative care (PC), voluntary stopping eating and drinking (VSED), and palliative sedation (PS). Palliative patients often ask healthcare providers to hasten their death, particularly during moments of suffering. In past, however, no legal options were available to address this request. In 2016 that changed. Canadians who meet eligibility requirements can now have MAiD whereby medications are used to induce death. Persons who request MAiD must be given the option of palliative care; however, it is widely recognized that there is a need to improve access to palliative care in Canada. Further, not all clients meet the eligibility criteria for MAiD, and in those cases, patients may resort to VSED or PS. Patients stop eating until they qualify for MAiD or they are sedated. With these evolving changes, there is a need to understand how the interactions between these approaches, and how broader social and demographic factors, are influencing these end-of-life decisions. Building upon research we are currently conducting, our aim in this project is to gain a thorough understanding of the developmental trajectory over an eight year period of policy and practice related to STRS-EOL. We will gather and analyze longitudinal data from policy documents, key stakeholders, and nurses with the goal of creating unique and highly sought after data to track and compare the developmental trajectory of STRS-EOL across English-speaking Canadian health regions over time. Through this knowledge we will support wide-spread uptake of STRS-EOL best practices and improved practitioner well-being and moral development.