This moral coil: a cross-sectional survey of Canadian medical student attitudes toward medical assistance in dying

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.

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Do medical student attitudes towards patients with chronic low back pain improve during training? a cross-sectional study

BMC Medical Education ◽

10.1186/1472-6920-12-10 ◽

2012 ◽

Vol 12 (1) ◽

Cited By ~ 21

Author(s):

Hayley Morris ◽

Cormac Ryan ◽

Douglas Lauchlan ◽

Max Field

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Medical Student ◽

Chronic Low Back Pain ◽

Student Attitudes ◽

Cross Sectional Study ◽

Low Back ◽

Sectional Study ◽

Cross Sectional ◽

Medical Student Attitudes

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The preliminary opinion of Canadian spine surgeons on Medical Assistance in Dying (MAID); a cross-sectional survey of Canadian Spine Society (CSS) members

North American Spine Society Journal (NASSJ) ◽

10.1016/j.xnsj.2020.100037 ◽

2020 ◽

Vol 4 ◽

pp. 100037

Author(s):

Erika Leck ◽

Sean Christie ◽

Tricia Barry ◽

Sean Barry

Keyword(s):

Medical Assistance ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Medical Assistance In Dying

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Cross-sectional study of Australian medical student attitudes towards older people confirms a four-factor structure and psychometric properties of the Australian Ageing Semantic Differential

BMJ Open ◽

10.1136/bmjopen-2019-036108 ◽

2020 ◽

Vol 10 (8) ◽

pp. e036108

Author(s):

Mark Wilson ◽

Yvonne Tran ◽

Ian Wilson ◽

Susan E Kurrle

Keyword(s):

Medical Student ◽

Older People ◽

Psychometric Properties ◽

Student Attitudes ◽

Factor Model ◽

Semantic Differential ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Medical Student Attitudes

ObjectivesThe Australian Ageing Semantic Differential (AASD) survey was developed to quantify medical student attitudes towards older people. The purpose of this study is to examine psychometric properties of the survey and confirm its factor structure of four composites.DesignA cross-sectional study.SettingThree medical schools in three Australian states: Victoria, Western Australia and South Australia.ParticipantsThird-year or fourth-year medical students (n=188, response rate=79%).Outcome measuresIn the previous AASD study, exploratory factor analysis supported a four-factor model consisting of ‘Instrumentality’ (I), ‘Personal Appeal’ (PA), ‘Experience’ (E) and ‘Sociability’ (S). Congeneric one-factor confirmatory factor analysis (CFA) were used to examine model fit for factors using a new student sample (n=188).Psychometric properties of survey items and factors.Post-hoc analysis of pooled data from this study and earlier AASD study (n=509).ResultsIndices of fit (Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), root mean square error of approximation (RMSEA), standardised root mean square residual (SRMR)) for data to the factor model were: PA adequate fit (CFI=0.94, TLI=0.89, RMSEA=0.11 and SRMR=0.05), I good fit (CFI=0.99, TLI=0.99, RMSEA=0.04 and SRMR=0.03), S good fit (CFI=0.98, TLI=0.95, RMSEA=0.06 and SRMR=0.03) and E excellent fit (CFI=1.0, TLI=1.0, RMSEA=0.00 and SRMR=0.01).The AASD was internally consistent (Cronbach’s alpha=0.84), without difference in mean student scores by institution. Mean AASD score was positive for medical students outside New South Wales (73.2/114).Mean I score for all Australian students was negative, with female respondents’ mean E score significantly higher than their counterparts. A positive correlation between student age and I score was noted.ConclusionsThe AASD is internally consistent and generalisable within Australia, with acceptable structural validity for measuring medical student attitudes towards older people within a four-factor model. Student attitudes were positive globally and within all factors except I. Female students rated older persons E more positively. Older students recorded more positive attitudes towards I of older people.

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

Journal of Medical Ethics ◽

10.1136/medethics-2018-105160 ◽

2019 ◽

Vol 45 (5) ◽

pp. 309-313 ◽

Cited By ~ 2

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.

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Effect of COVID-19 on Canadian Medical Student Attitudes toward Ophthalmology Residency Application

Journal of Academic Ophthalmology ◽

10.1055/s-0040-1722740 ◽

2021 ◽

Vol 13 (01) ◽

pp. e5-e10

Author(s):

Cody Lo ◽

Amandeep Rai ◽

Jonathan A. Micieli

Keyword(s):

Medical Students ◽

Student Attitudes ◽

Program Directors ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Survey Tool ◽

Medical Student Attitudes ◽

Negative Impacts ◽

Novel Coronavirus ◽

Residency Application

Abstract Objective This study aims to survey medical students interested in ophthalmology about how changes in electives and Canadian Residency Matching Service (CaRMS) due to the novel coronavirus disease 2019 (COVID-19) pandemic have affected their attitudes toward applying to ophthalmology residency. Design This is a cross-sectional survey. Participants A total of 32 Canadian medical students interested in ophthalmology responded to the survey. Methods A 32-question survey tool used was developed in consultation with medical students, academic ophthalmologists, and residency program directors. The survey was distributed through e-mail by local ophthalmology interest groups at all of Canada's medical schools. Results Respondents felt that changes in ability to travel for electives significantly decreased their likelihood of applying to ophthalmology residency. Additionally, respondents expressed concerns that lack of travel for electives and in-person CaRMS interviews significantly reduced their chances of successfully matching to ophthalmology. Respondents identified one-on-one video calls with program directors and residents as the initiatives that would best counteract the negative impacts from COVID-19. Increased presence of programs on social media were relatively less valued. Conclusion Canadian medical students interested in ophthalmology have concerns about how changes in electives and the CaRMS match due to COVID-19 will impact their ability to be fairly assessed and successfully match to ophthalmology. Lack of travel for electives and interviews has also resulted in students feeling ill equipped to make informed choices about program selection. However, there remains a sustained interest in ophthalmology among applicants.

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