scholarly journals P.117 The opinion of Canadian spine surgeons on medical assistance in dying (MAID); a cross-sectional survey of Canadian spine society (CSS) members

2019 ◽  
Vol 46 (s1) ◽  
pp. S44
Author(s):  
E Leck ◽  
S Barry ◽  
S Christie
Keyword(s):  
Cervical Spinal Cord ◽  
Criminal Code ◽  
Supreme Court Of Canada ◽  
Medical Assistance ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Assistance In Dying ◽  
Cord Injury ◽  
The Right ◽  
Spine Tumour

Background: On February 6, 2015, the Supreme Court of Canada struck down the Criminal Code absolute prohibition on assisted dying, and in June 2016 the new law, Bill C-14, came into effect allowing for medical assistance in dying. We sought to determine the attitudes and opinions of Canadian neurosurgeons and orthopedic spine surgeons regarding MAID. Methods: A cross-sectional survey was sent out to members of the Canadian Spine Society (CSS), which included 21 questions pertaining to opinions regarding MAID. Responses were collected between May-June 2016. Results: A total of 51 surgeons responded to the survey, comprised of a mix of spine surgeons from across the country. The majority of surgeons supported MAID (62.8%), and right of physicians to participate (82.4%). Most surgeons supported the right to conscientious objection (90.1%), but also mandatory duty to refer (49.0%). The conditions most frequently felt to be appropriate for MAID included metastatic spine tumour (76.5%), malignant intramedullary tumour (64.7%), primary malignant spine tumour (54.9%), cervical spinal cord injury with tetraplegia (49.0%) and multiple myeloma (33.3%). Conclusions: This study highlights the complex landscape that exists when discussing MAID, but also the overall support of physicians, and need for ongoing conversations, particularly with issues not addressed by the current legislation.

Canadian neurosurgeons’ views on medical assistance in dying (MAID): a cross-sectional survey of Canadian Neurosurgical Society (CNSS) members

2019 ◽  
Vol 45 (5) ◽  
pp. 309-313 ◽  
Author(s):  
Alwalaa Althagafi ◽  
Chris Ekong ◽  
Brian W Wheelock ◽  
Richard Moulton ◽  
Peter Gorman ◽  
...  
Keyword(s):  
Position Statement ◽  
Conscientious Objection ◽  
Supreme Court Of Canada ◽  
Medical Assistance ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Assistance In Dying ◽  
Neurosurgical Society ◽  
Views And Perceptions ◽  
The Right

BackgroundThe Supreme Court of Canada removed the prohibition on physicians assisting in patients dying on 6 February 2015. Bill C-14, legalising medical assistance in dying (MAID) in Canada, was subsequently passed by the House of Commons and the Senate on 17 June 2016. As this remains a divisive issue for physicians, the Canadian Neurosurgical Society (CNSS) has recently published a position statement on MAID.MethodsWe conducted a cross-sectional survey to understand the views and perceptions among CNSS members regarding MAID to inform its position statement on the issue. Data was collected from May to June 2016.ResultsOf the 300 active membes of the CNSS who recevied the survey, 89 respondents completed the survey, 71% of whom were attending neurosurgeons and 29% were neurosurgery residents. Most respondents,74.2%, supported the right of physicians to participate in MAID with 7.8% opposing. 37% had current patients in their practice fitting the criteria for MAID. 23.6% had been asked by patients to assist with MAID, but only 11% would consider personally providing it. 84% of neurosurgeons surveyed supported the physicians’ right to conscientious objection to MAID while 21% thought attending surgeons should be removed from the inquiry and decision-making process. 43.8% agreed that the requirment to refer a patient to a MAID service should be mandatory. Glioblastoma multiforme (65%), quadriplegia/quadriparesis secondary to spinal tumour/trauma (54%) and Parkinson’s disease (24%) were the most common suggested potential indications for MAID among the neurosurgical population.ConclusionsOur results demonstrate that most neurosurgeons in Canada are generally supportive of MAID in select patients. However, they also strongly support the physicians’ right to conscientious objection.

scholarly journals Medical Assistance in Dying in Canada: An Ethical Analysis of Conscientious and Religious Objections

2018 ◽  
Vol 5 ◽  
Author(s):  
Timothy Christie ◽  
John Sloan ◽  
Dylan Dahlgren ◽  
Fred Koning
Keyword(s):  
Health Care Professionals ◽  
Criminal Code ◽  
Conscientious Objection ◽  
Supreme Court Of Canada ◽  
Conscientious Objector ◽  
Medical Assistance ◽  
Right To Life ◽  
Medical Assistance In Dying ◽  
Deontological Ethics ◽  
The Right

Background: The Supreme Court of Canada (SCC) has ruled that the federal government is required to remove the provisions of the Criminal Code of Canada that prohibit medical assistance in dying (MAID). The SCC has stipulated that individual physicians will not be required to provide MAID should they have a religious or conscientious objection. Therefore, the pending legislative response will have to balance the rights of the patients with the rights of physicians, other health care professionals, and objecting institutions. Objective: The objective of this paper is to critically assess, within the Canadian context, the moral probity of individual or institutional objections to MAID that are for either religious or conscientious reasons. Methods: Deontological ethics and the Doctrine of Double Effect. Results: The religious or conscientious objector has conflicting duties, i.e., a duty to respect the “right to life” (section 7 of the Charter) and a duty to respect the tenets of his or her religious or conscientious beliefs (protected by section 2 of the Charter). Conclusion: The discussion of religious or conscientious objections to MAID has not explicitly considered the competing duties of the conscientious objector. It has focussed on the fact that a conscientious objection exists and has ignored the normative question of whether the duty to respect one’s conscience or religion supersedes the duty to respect the patient’s right to life.

A gap between Law and Practice: A Community’s Perception of Unmarried Women’s Abortion Options in Nepal

2014 ◽  
Vol 12 (2) ◽  
pp. 24-30
Author(s):  
Simone Christensen Hald ◽  
Ditte Aagaard Sondergaard
Keyword(s):  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Safe Abortion ◽  
Community Attitudes ◽  
Abortion Law ◽  
Premarital Sexual Activity ◽  
Premarital Sexual ◽  
The Right ◽  
Changing Attitudes ◽  
Depth Interviews

Background In 2002, the Nepalese abortion law went from being highly restrictive to fully liberal. This study aimed to explore a local community’s perception of the situation for unmarried Nepalese women wanting to practice their legal right to abortion.Methods The study comprised a cross-sectional survey and in-depth interviews with men and women above the age of 16 years living in the Makwanpur District, Nepal. The final data included 55 questionnaires and 16 interviews. The questionnaire data was univariate analysed, while a condensation of meaning analysis was carried out on the interviews.Results The overall awareness of abortion being legal was high, although the extent of knowledge of the specific legal grounds varied. Unmarried women were believed to have access to abortion services, although they risked stigmatisation due to their marital status. The community attitude towards these women having abortions was very negative, hence it differed from the legal acceptance of all women having the right to abortion. This was explained by societal norms on premarital sexual activity. Generally, the participants felt that changing attitudes would be difficult but possible over time.Conclusion A considerable gap exists between the legal acceptance of abortion and community attitudes when it comes to unmarried women as this group encounters barriers when wanting to practice their right. Therefore, these barriers need to be addressed to allow unmarried Nepalese women access to safe abortion services without the risk of being stigmatised.One possible alternative is educational initiatives such as disseminating information vigorously through mass media to create awareness.DOI: http://dx.doi.org/10.3126/hprospect.v12i2.9869 Health Prospect Vol.12(2) 2013: 24-30

scholarly journals Perceptions on the right to adequate food after a major landslide disaster: a cross-sectional survey of two districts in Uganda

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Peter M Rukundo ◽  
Per O Iversen ◽  
Bård A Andreassen ◽  
Arne Oshaug ◽  
Joyce Kikafunda ◽  
...  
Keyword(s):  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Adequate Food ◽  
The Right ◽  
Landslide Disaster

scholarly journals Medicine Facing Death: Attitudes Toward Physician-Assisted End of Life – A Cross-Sectional Study

2021 ◽  
Author(s):  
Keren Dopelt ◽  
Dganit Cohen ◽  
Einat Amar-Krispel ◽  
Davidovitch ◽  
Paul Barach
Keyword(s):  
End Of Life ◽  
Human Life ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Medical Assistance In Dying ◽  
Empathic Communication ◽  
Wish To Die ◽  
The Right

Abstract Background: The demand for medical assistance in dying remains high and controversial. The "Dying Patient Act" (2005) legalized requiring Israeli patients to receive medical guidance regarding the care (or non-treatment) they seek at the end of life. Many doctors have made it clear that helping a patient die is opposed by their values and professional goals.Objective: To explore the attitudes of physicians regarding euthanasia and examine the factors that related to these attitudes.Methods: We conducted a cross sectional prospective study in Israel, during January-February 2019. We used logistic regression analyses to describe the association of demographic and professional factors with attitudes toward physician-assisted end of life.Results: We surveyed 135 physicians working at a tertiary-care-hospital about their attitudes regarding euthanasia. About 61% agreed that a person has the right to decide whether to expedite their own death, 54% agreed that euthanasia should be allowed, while 29% thought that physicians should preserve a patient's life even if they expressed the wish to die. Conclusion: The data shows a conflict of values: the sacredness of human life versus the desire to alleviate patient's suffering. Coronavirus outbreak reinforces the urgency of our findings and raises the importance of supporting physicians' efforts to provide ethical, and empathic communication for terminally ill patients. Future studies should aim to improve our understanding and treatment of the specific types of suffering that lead to end-of-life requests.

scholarly journals Iodine and pregnancy – a UK cross-sectional survey of dietary intake, knowledge and awareness

2015 ◽  
Vol 114 (1) ◽  
pp. 108-117 ◽  
Author(s):  
E. Combet ◽  
M. Bouga ◽  
B. Pan ◽  
M. E. J. Lean ◽  
C. O. Christopher
Keyword(s):  
Iodine Intake ◽  
Dietary Recommendations ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Nutritional Recommendations ◽  
Level Of Confidence ◽  
Healthy Growth ◽  
The Uk ◽  
The Right ◽  
In Pregnancy

Iodine is a key component of the thyroid hormones, which are critical for healthy growth, development and metabolism. The UK population is now classified as mildly iodine-insufficient. Adequate levels of iodine during pregnancy are essential for fetal neurodevelopment, and mild iodine deficiency is linked to developmental impairments. In the absence of prophylaxis in the UK, awareness of nutritional recommendations during pregnancy would empower mothers to make the right dietary choices leading to adequate iodine intake. The present study aimed to: estimate mothers' dietary iodine intake in pregnancy (using a FFQ); assess awareness of the importance of iodine in pregnancy with an understanding of existing pregnancy dietary and lifestyle recommendations with relevance for iodine; examine the level of confidence in meeting adequate iodine intake. A cross-sectional survey was conducted and questionnaires were distributed between August 2011 and February 2012 on local (Glasgow) and national levels (online electronic questionnaire); 1026 women, UK-resident and pregnant or mother to a child aged up to 36 months participated in the study. While self-reported awareness about general nutritional recommendations during pregnancy was high (96 %), awareness of iodine-specific recommendations was very low (12 %), as well as the level of confidence of how to achieve adequate iodine intake (28 %). Median pregnancy iodine intake, without supplements, calculated from the FFQ, was 190 μg/d (interquartile range 144–256μg/d), which was lower than that of the WHO's recommended intake for pregnant women (250 μg/d). Current dietary recommendations in pregnancy, and their dissemination, are found not to equip women to meet the requirements for iodine intake.

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