Canadian Undergraduates’ Perspectives on Medical Assistance in Dying (MAiD): A Quantitative Study

2021 ◽  
pp. 082585972110507
Author(s):  
Erin Hawrelak ◽  
Lori Harper ◽  
John R. Reddon ◽  
Russell A. Powell
Keyword(s):  
Mental Illness ◽  
Undergraduate Students ◽  
Mentally Ill ◽  
Life Experiences ◽  
Medical Condition ◽  
Mental Illnesses ◽  
Medical Assistance ◽  
Factors Associated ◽  
Medical Assistance In Dying ◽  
Religion And Ethnicity

Background and Objectives: In 2016, Medical Assistance in Dying (MAiD) became legal in Canada for those suffering a grievous and untreatable medical condition. Currently, it is not available to minors or to those with an untreatable mental illness, although it is likely the scope of MAiD will be widened to include persons with severe and untreatable mental illnesses. However, little is known about the factors predicting acceptance or rejection of MAiD for persons with either a grievous medical condition or an untreatable mental illness. Methods: A survey was administered to 438 undergraduate students to examine factors associated with their acceptance or rejection of MAiD. The survey included four different scenarios: a young or old person with an untreatable medical condition, and a young or old person with an untreatable mental illness. Demographic questions (age, sex, religion, etc), personality measures, and an attitude towards euthanasia scale were also administered, as well as questions assessing participants’ general understanding of MAiD and their life experiences with death and suicide. Results/Conclusion: Overall, most of the Canadian undergraduate participants accepted MAiD for both terminally ill and mentally ill patients; however, different variables, such as age, religion, and ethnicity, predicted the acceptance or rejection of MAiD for each scenario.

scholarly journals Level of compliance and factors associated with non-compliance to treatment among the mentally ill patients

2012 ◽  
Vol 10 (2) ◽  
pp. 113-117 ◽  
Author(s):  
S Lama ◽  
K V Lakshmi ◽  
P M Shyangwa ◽  
P Parajuli
Keyword(s):  
Mental Illness ◽  
Mentally Ill ◽  
Mental Illnesses ◽  
Psychiatric Ward ◽  
Psychiatric Medication ◽  
Drug Compliance ◽  
Treatment Access ◽  
Related Factors ◽  
Factors Associated ◽  
Compliance To Treatment

Background: Mental illnesses are treatable and need medication and other therapies i.e. counseling, psychotherapy etc for the better outcome. Poor adherence to psychiatric medication regimens is a major obstacle to the effective care of persons who have chronic mental illness.Objectives: The study aims to identify the level of compliance and factors associated with non-compliance to treatment regimen.Methods: This was a hospital based cross sectional study carried out in psychiatric ward and OPD at B.P.Koirala Institute of Health Sciences, Dharan Nepal. A total of 150 patients were included as study samples using purposive sampling technique. Data was collected using self developed, pre tested, semi structured Pro forma by interview method.Results: Half of the patients showed average compliance. Thirty seven percentages of patients had good compliance and only 13% showed poor compliance. There was no association between drug compliance and demographic variables (p> 0.05). Drug compliance was significantly associated with factors such as drug related aspects, treatment access related factors, quality of interaction with treating team, family support, attitude towards mental illness and relatives' insight towards mental illness (p<0.05 ).Conclusion: The findings of the study highlighted the various factors such as drug related, social support, and treatment access related factors are influencing the drug compliance among the mentally ill patients.DOI: http://dx.doi.org/10.3126/hren.v10i2.6577 Health Renaissance 2012; Vol 10 (No.2); 113-117 

scholarly journals “For Their Own Good”: A Response to Popular Arguments Against Permitting Medical Assistance in Dying (MAID) where Mental Illness Is the Sole Underlying Condition

2018 ◽  
Vol 63 (7) ◽  
pp. 451-456 ◽  
Author(s):  
Justine Dembo ◽  
Udo Schuklenk ◽  
Jonathan Reggler
Keyword(s):  
Mental Illness ◽  
Patient Autonomy ◽  
Medical Condition ◽  
Value Of Life ◽  
Natural Death ◽  
Medical Assistance ◽  
Liberal Democracies ◽  
Medical Assistance In Dying ◽  
Underlying Medical Condition

Canada is approaching its federal government’s review of whether patients should be eligible for medical assistance in dying (MAID) where mental illness is the sole underlying medical condition, and when “natural death” is not “reasonably foreseeable”. For those opposed, arguments involve the following themes: capacity, value of life, vulnerability, stigma, irremediability, and the role of physicians. It has also been suggested that those who are able-bodied should have to kill themselves, even though suicide may be painful, lonely, and violent. Opponents of MAID for severe, refractory suffering due to mental illness imply that it is acceptable to remove agency from such patients on paternalistic grounds. After years of efforts to destigmatise mental illness, these kinds of arguments effectively declare all patients with mental illness, regardless of capacity, unable to make considered choices for themselves. The current paper argues that decisions about capacity must be made on an individual-patient basis. Given the rightful importance granted to respect for patient autonomy in liberal democracies, the wholesale removal of agency advocated by opponents of a permissive MAID regime is difficult to reconcile with Canadian constitutional values.

Making a case for the inclusion of refractory and severe mental illness as a sole criterion for Canadians requesting medical assistance in dying (MAiD): a review

2021 ◽  
pp. medethics-2020-107133
Author(s):  
Anees Bahji ◽  
Nicholas Delva
Keyword(s):  
Mental Illness ◽  
Assisted Suicide ◽  
Medical Condition ◽  
Psychiatric Patients ◽  
Public Support ◽  
Medical Assistance ◽  
Assisted Death ◽  
Medical Assistance In Dying ◽  
Legislative Framework ◽  
Sole Criterion

BackgroundFollowing several landmark rulings and increasing public support for physician-assisted death, in 2016, Canada became one of a handful of countries legalising medical assistance in dying (MAiD) with Bill C-14. However, the revised Bill C-7 proposes the specific exclusion of MAiD where a mental disorder is the sole underlying medical condition (MAiD MD-SUMC).AimThis review explores how some persons with serious and persistent mental illness (SPMI) could meet sensible and just criteria for MAiD under the Canadian legislative framework.MethodsWe review the proposed Bill C-7 criteria (capacity, voluntariness, irremediability and suffering) as well as the nuances involved in separating a well-reasoned request for assisted suicide from what might be solely a manifestation of a SPMI.FindingsIn this paper, we argue against the absolute exclusion of patients with SPMIs from accessing MAiD. Instead, we propose that in some circumstances, MAiD MD-SUMC may be justifiable while remaining the last resort. Conducting MAiD eligibility assessments removes the need to introduce diagnosis-specific language into MAiD legislation. Competent psychiatric patients who request MAiD should not be treated any differently from other eligible candidates. Many individuals with psychiatric disorders will be incapable of consenting to MAiD. The only ethical option is to assess eligibility for MAiD on an individual basis and include as legitimate candidates those who suffer solely from psychiatric illness who have the decisional capacity to consent to MAiD.

Offenders with Mental Illness in Prison

2016 ◽  
Author(s):  
Sarah M. Manchak ◽  
Robert D. Morgan
Keyword(s):  
Mental Illness ◽  
Mentally Ill ◽  
Justice System ◽  
Mental Illnesses ◽  
Future Research ◽  
Mentally Disordered Offenders ◽  
Prison Management ◽  
Mentally Disordered ◽  
Prison Environment ◽  
Offenders With Mental Illness

This essay describes trends in the number of mentally disordered offenders in prison and the unique challenges posed by them in terms of prison management and service delivery. The essay first explores why persons with mental illnesses are overrepresented in the criminal justice system, then discusses efforts to rehabilitate this population should not take place within the prison environment (and, if they do, what changes in current practices are necessary to adapt to the prison setting). How the challenges posed by mentally ill inmates are managed is also covered, with critical discussions of these strategies. Finally, an analysis of the changes that are needed to improve conditions for inmates with mental illness in prisons is presented, with a description of one promising program for treating these offenders. Suggestions for future research with this population that will help inform and improve prison conditions for offenders with mental illness are also provided.

scholarly journals Tensions and Paradoxes of Stigma: Discussing Stigma in Mental Health Rehabilitation

2020 ◽  
Vol 17 (16) ◽  
pp. 5943
Author(s):  
Jenny Paananen ◽  
Camilla Lindholm ◽  
Melisa Stevanovic ◽  
Elina Weiste
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Professionals ◽  
Mentally Ill ◽  
Media Coverage ◽  
Mental Health Problems ◽  
Mental Illnesses ◽  
Rehabilitation Centers ◽  
Health Rehabilitation ◽  
Mental Health Rehabilitation

Mental illness remains as one of the most stigmatizing conditions in contemporary western societies. This study sheds light on how mental health professionals and rehabilitants perceive stigmatization. The qualitative study is based on stimulated focus group interviews conducted in five Finnish mental health rehabilitation centers that follow the Clubhouse model. The findings were analyzed through inductive content analysis. Both the mental health rehabilitants and the professionals perceived stigmatization as a phenomenon that concerns the majority of rehabilitants. However, whereas the professionals viewed stigma as something that is inflicted upon the mentally ill from the outside, the rehabilitants perceived stigma as something that the mentally ill themselves can influence by advancing their own confidence, shame management, and recovery. Improvements in treatment, along with media coverage, were seen as the factors that reduce stigmatization, but the same conceptualization did not hold for serious mental illnesses. As the average Clubhouse client was thought to be a person with serious mental illness, the rehabilitation context designed to normalize attitudes toward mental health problems was paradoxically perceived to enforce the concept of inevitable stigma. Therefore, it is important for professionals in rehabilitation communities to be reflexively aware of these tensions when supporting the rehabilitants.

scholarly journals Analysis of the Medical Assistance in Dying Cases in Ontario: Understanding the Patient Demographics of Case Uptake in Ontario since the Royal Assent and Amendments of Bill C-14 in Canada

2017 ◽  
Vol 7 (2) ◽  
pp. 263-287 ◽  
Author(s):  
Alexandra E. Rosso ◽  
Dirk Huyer ◽  
Alfredo Walker
Keyword(s):  
Nurse Practitioners ◽  
Medical Condition ◽  
Medical Personnel ◽  
Drug Regimen ◽  
Criminal Code ◽  
Medical Assistance ◽  
Eligibility Criteria ◽  
Medical Assistance In Dying ◽  
Patient Demographics ◽  
The Individual

On June 17, 2016, the Canadian government legalized medical assistance in dying (MAID) across the country by giving Royal Assent to Bill C-14. This Act made amendments to the Criminal Code and other Acts relating to MAID, allowing physicians and nurse practitioners to offer clinician-administered and self-administered MAID in conjunction with pharmacists being able to dispense the necessary medications. The eligibility criteria for MAID indicates that the individual 1) must be a recipient of publicly funded health services in Canada, 2) be at least 18 years of age, 3) be capable of health-related decision-making, and 4) has a grievous and irremediable medical condition. Because this is a new practice in Canadian health care, there are no published Canadian statistics on MAID cases to date, and this paper constitutes the first analysis of MAID cases in both the province of Ontario and Canada. Internationally, there are only a few jurisdictions with similar legislation already in place (US, the Netherlands, Belgium, Luxembourg, Switzerland, Columbia, Japan, and the United Kingdom). The published statistics on MAID cases from these jurisdictions were reviewed and used to establish the current global practices and demographics of MAID and will provide useful comparisons for Canada. This analysis will 1) outline the Canadian legislative approach to MAID, 2) provide an understanding of which patient populations in Ontario are using MAID and under what circumstances, and 3) determine if patterns exist between the internationally published MAID patient demographics and the Canadian MAID data. Selected patient demographics of the first 100 MAID cases in Ontario were reviewed and analyzed using anonymized data obtained from the Office of the Chief Coroner for Ontario so that an insight into the provision of MAID in Ontario could be obtained. Demographic factors such as age, sex, the primary medical diagnosis that prompted the request for MAID, the patient rationale for making a MAID request, the place where MAID was administered, the nature of MAID drug regimen used, and the status/specialty of medical personnel who administered the MAID drug regimen were analyzed. The analysis revealed that the majority of the first 100 MAID recipients were older adults (only 5.2% of patients were aged 35-54 years, with no younger adults between ages 18-34 years) who were afflicted with cancer (64%) and had opted for clinician-administered MAID (99%) that had been delivered in either a hospital (38.8%) or private residence (44.9%). Although the cohort was small, these Ontario MAID demographics reflect similar observations as those published internationally, but further analysis of both larger and annual case uptake in both Ontario and Canada will be conducted as the number of cases increases.

Biological Sex, Adherence to Traditional Gender Roles, and Attitudes Toward Persons with Mental Illness: An Exploratory Investigation

2003 ◽  
Vol 25 (4) ◽  
pp. 259-270 ◽  
Author(s):  
Lisa Hinkelman ◽  
Darcy Haag Granello
Keyword(s):  
Gender Roles ◽  
Undergraduate Students ◽  
Mentally Ill ◽  
Mental Illnesses ◽  
Future Research ◽  
Mental Health Counselors ◽  
Community Attitudes ◽  
Biological Sex ◽  
Traditional Gender Roles ◽  
Exploratory Investigation

Undergraduate students (n = 86) responded to the Community Attitudes Toward the Mentally Ill (CAMI) questionnaire and The Hypergender Ideology Scale, which measures the degree to which they adhered to traditional gender roles. Results indicated that males were significantly more likely than females to endorse intolerant attitudes toward persons with mental illnesses. However, when adherence to hypergender ideology was controlled for, no significant differences emerged between the genders. It was determined that strict gender-role adherence, rather than biological sex, accounted for the variance in CAMI scores. Implications for mental health counselors and for selecting predictor variables for future research are discussed.

scholarly journals Medical Assistance in Dying and Mental Health: A Legal, Ethical, and Clinical Analysis

2017 ◽  
Vol 63 (2) ◽  
pp. 80-84 ◽  
Author(s):  
Alexander I. F. Simpson
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Clinical Analysis ◽  
Psychiatric Practice ◽  
Eligibility Criterion ◽  
Medical Assistance ◽  
Medical Assistance In Dying

Medical assistance in dying (MAiD) legislation is now over a year old in Canada, and consideration is turning to whether MAiD should be extended to include serious mental illness as the sole qualifying condition for being eligible for MAiD. This article considers this question from ethical and clinical perspectives. It argues that extending the eligibility for MAiD to include those with a serious mental illness as the sole eligibility criterion is not ethical, necessary, or supported current psychiatric practice or opinion.

scholarly journals Insanity in a Sea of Islands: Mobility and Mental Health in Aotearoa New Zealand’s Pacific Sphere

2021 ◽  
Author(s):  
Jacqueline Leckie
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mentally Ill ◽  
Pacific Islands ◽  
South Pacific ◽  
Mental Illnesses ◽  
Historical Evidence ◽  
The Pacific

This article builds upon the fragmentary historical evidence of mental illness and mental health within South Pacific societies to explore the nexus with migration and mobility. The focus is on the Pacific territories that were under Aotearoa New Zealand’s jurisdiction. The article explores concepts of mental health and mobility within Pacific societies that became entangled with European concepts to designate insanity. The paper then discusses how mental illnesses were exacerbated or induced through migration and travel across the Pacific. The last section explores the transfer of mentally ill patients from some Pacific islands to Aotearoa. This article is based upon the 2018 J. D. Stout Lecture at Victoria University of Wellington.

Between Sanity and Madness

2019 ◽  
Author(s):  
Allan V. Horwitz
Keyword(s):  
Mental Illness ◽  
Mentally Ill ◽  
Ancient Greece ◽  
Mental Illnesses

Between Sanity and Madness: Mental Illness from Ancient Greece to the Neuroscientific Era traces the extensive array of answers that various groups have provided to questions about the nature of mental illness and its boundaries with sanity. What distinguishes mental illnesses from other sorts of devalued conditions and from normality? Should medical, religious, psychological, legal, or no authority at all respond to the mentally ill? Why do some people become mad? What treatments might help them recover? Despite general agreement across societies regarding definitions about the pole of madness, huge disparities exist on where dividing lines should be placed between it and sanity and even if there is any clear demarcation at all. Various groups have provided answers to these puzzles that are both widely divergent and surprisingly similar to current understandings.

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