In a Familiar Voice: The Dominant Role of Women in Shaping Canadian Policy on Medical Assistance in Dying

Background Recently published findings emphasize the dominant role of women in the donation discussion. With some noteworthy exceptions, the empirical literature on gender and donation, and the role of gender in healthcare decisions as well as donation, is limited. Objectives To provide preliminary information needed to begin theoretical or framework development and to initiate more rigorous research on the role of gender in donation discussions. Design This exploratory study is a descriptive qualitative retrospective study using focus group methodology. Setting and Participants Two focus groups were conducted in 2 major cities in the organ procurement organization's service area. Participants were women who were involved in the donation discussion within the past 5 years; 6 participated in 1 session, 8 in the other. Results The focus group discussions highlight the role of women in the donation process relative to information needs, information usage, and the ensuring dynamics of the donation discussion. Compared to men, women tend to seek more information and reframe this information for others. Because women are frequently central in family communication networks, they serve as a communication conduit for other family members and may influence others. Conclusions Involving key women decision makers in the early stages of the donation discussion and providing information elaboration build on women's central placement and role in family communication network processes. The significance of women's central placement may carry cultural implications, particularly for racial or ethnic groups with strong matriarchal or extended kinship structures.

Download Full-text

Peran Penjaga Perdamaian Wanita dalam Proses Bina-Damai: Studi Kasus Operasi Perdamaian Monusco

Global South Review ◽

10.22146/globalsouth.28851 ◽

2017 ◽

Vol 2 (1) ◽

pp. 51

Author(s):

Satwika Paramasatya

Keyword(s):

United Nations ◽

Dominant Role ◽

Peace Process ◽

Peace Building ◽

Peace Operations ◽

Military Cooperation ◽

Peacekeeping Operations ◽

Building Process ◽

Role Of Women

Peacekeeping Operations (PKO) is known as an instrument used by the United Nations to create peace in countries affected by conflict. Peacekeeping operations work as a mediator for the parties of the conflict and to ensure that violence no longer exists in the peace process. Once peace is achieved, peace operations are expected to remain involved in the peace building process. At first, men played a very dominant role in peacekeeping operations. Even so, women have been more involved in peace operations nowadays. It can be seen from the increasing number of female members of peacekeeping operations. This paper will discuss the role of women in contributing to the peace building process that occur in the MONUSCO operation in Congo. Congo was chosen because MONUSCO has the highest female members compared to other peacekeeping operations. The research was conducted by using explanatory method to analyze the role of women in peacekeeping operation using parameters such as the implementation of the mandate, the consistency of the implementation of Capstone Doctrine, DDR (Disarmament, demobilization, Reintegration), and CIMIC (Civil-Military Cooperation). The result indicated that women tend to have positive influences towards peace building process in peacekeeping operations judging from the fulfillment of the mandate and the implementation of programs that support the peacekeeping operation itself.

Download Full-text

Women, Climate Change and Economic Problems in the Family

GATR Journal of Management and Marketing Review - JMMR Vol 4(3) JUL-SEP 2019 ◽

10.35609/jmmr.2017.2.3(8) ◽

2017 ◽

Vol 2 (3) ◽

pp. 55-60

Author(s):

Mientje Ratoe Oedjoe ◽

Rolland Epafras Fanggidae

Keyword(s):

Climate Change ◽

Dominant Role ◽

Climate Change Impacts ◽

Jel Classification ◽

Domestic Activity ◽

Quantitative And Qualitative Research ◽

The Face ◽

Role Of Women ◽

Women's Role

Objective - The role of women in Indonesia, particularly in East Nusa Tenggara in domestic activity very dominant. This study focuses on the efforts made by women cope with the impacts of climate change. Methodology/Technique - Methods used are mixture of quantitative and qualitative research. While the location of the research conducted in Kupang regency, East Nusa Tenggara. Findings – The study of the results showed that, women are still playing a dominant role in getting a sufficient supply of staple foods and meal replacements basic needs and outside work done in the event of extreme climatic impacts on the ocean. Novelty - This research looks at the optimal empowerment of women's role in addressing climate change and learn to know how the role of women in the economic field in the face of climate change impacts. Type of Paper - Empirical Keywords: Climate Change; Women; Women's Roles; Gender; Family. JEL Classification: J16, Q10, Q50.

Download Full-text

Provision of medical assistance in dying: a scoping review

BMJ Open ◽

10.1136/bmjopen-2019-036054 ◽

2020 ◽

Vol 10 (7) ◽

pp. e036054

Author(s):

Max Zworth ◽

Carol Saleh ◽

Ian Ball ◽

Gaelen Kalles ◽

Anatoli Chkaroubo ◽

...

Keyword(s):

Scoping Review ◽

Future Research ◽

Medical Assistance ◽

Self Administration ◽

Eligibility Criteria ◽

Medical Assistance In Dying ◽

Oral Medications ◽

Clinical Trial Registries ◽

Oral Agents

ObjectivesThe purpose of this study is to map the characteristics of the existing medical literature describing the medications, settings, participants and outcomes of medical assistance in dying (MAID) in order to identify knowledge gaps and areas for future research.DesignScoping review.Search strategyWe searched electronic databases (MEDLINE, EMBASE, PsychINFO, CINAHL and CENTRAL), clinical trial registries, conference abstracts and professional guidelines from jurisdictions where MAID is legal, up to February 2020. Eligible report types included technical summaries, institutional policies, practice surveys, practice guidelines and clinical studies that describe MAID provision in adults who have provided informed consent for MAID.Results163 articles published between 1989 and 2020 met eligibility criteria. 75 studies described details for MAID administered by intravenous medications and 50 studies provided data on oral medications. In intravenous protocols, MAID was most commonly administered using a barbiturate (34/163) or propofol (22/163) followed by a neuromuscular blocker. Oral protocols most often used barbiturates alone (37/163) or in conjunction with an opioid medication (7/163) and often recommended using a prokinetic agent prior to lethal drug ingestion. Complications included prolonged duration of the dying process, difficulty in obtaining intravenous access and difficulty in swallowing oral agents. Most commonly, the role of physicians was prescribing (83/163) and administering medications (75/163). Nurses’ roles included administering medications (17/163) and supporting the patient (16/163) or family (13/163). The role of families involved providing support to the patient (17/163) and bringing medications from the pharmacy for self-administration (4/163).ConclusionsWe identified several trends in MAID provision including common medications and doses for oral and parenteral administration, roles of healthcare professionals and families, and complications that may cause patient, family and provider distress. Future research should aim to identify the medications, dosages, and administration techniques and procedures that produce the most predictable outcomes and mitigate distress for those involved.

Download Full-text

Exit Music: The Experience of Music Therapy within Medical Assistance in Dying

Healthcare ◽

10.3390/healthcare8030331 ◽

2020 ◽

Vol 8 (3) ◽

pp. 331

Author(s):

SarahRose Black ◽

Lee Bartel ◽

Gary Rodin

Keyword(s):

Music Therapy ◽

Lived Experience ◽

Medical Assistance ◽

Music Therapists ◽

Music Therapist ◽

Hermeneutic Phenomenological ◽

Medical Assistance In Dying ◽

Canadian Music

Since the 2015 Canadian legalization of medical assistance in dying (MAiD), many Canadian music therapists have become involved in the care of those requesting this procedure. This qualitative study, the first of its kind, examines the experience of music therapy within MAiD, exploring lived experience from three perspectives: the patient, their primary caregiver, and the music therapist/researcher. Overall thematic findings of a hermeneutic phenomenological analysis of ten MAiD cases demonstrate therapeutically beneficial outcomes in terms of quality of life, symptom management, and life review. Further research is merited to continue an exploration of the role of music therapy in the context of assisted dying.

Download Full-text

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

The Canadian Journal of Psychiatry ◽

10.1177/0706743718766055 ◽

2018 ◽

Vol 63 (7) ◽

pp. 451-456 ◽

Cited By ~ 13

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.

Download Full-text

Nurse leaders’ role in medical assistance in dying: A relational ethics approach

Nursing Ethics ◽

10.1177/0969733017730684 ◽

2017 ◽

Vol 26 (4) ◽

pp. 993-999 ◽

Cited By ~ 6

Author(s):

Tracy Thiele ◽

Jennifer Dunsford

Keyword(s):

Moral Dilemmas ◽

Routine Care ◽

Criminal Code ◽

Nursing Leadership ◽

Relational Ethics ◽

Medical Assistance ◽

Ethics Framework ◽

Medical Assistance In Dying ◽

The Individual

Recent changes to the Criminal Code of Canada have resulted in the right of competent adult Canadians to request medical assistance in dying (MAID). Healthcare professionals now can participate if the individual meets specific outlined criteria. There remains confusion and lack of knowledge about the specific role of nurses in MAID. MAID is a controversial topic and nurses may be faced with the challenge of balancing the duty to provide routine care, with moral reservations about MAID. The role of a nursing leader is to support nurses by ensuring they have the knowledge they require to care for patients requesting the service, whether or not the nurse is directly involved in the MAID process. The moral dilemmas raised by MAID provide an opportunity to look at a relational ethics approach to nursing leadership both for MAID and other difficult situations that arise in nursing practice. Relational ethics is a framework that proposes that the ethical moments in healthcare are based on relationships and fostering growth, healing, and health through the foundational concepts of mutual respect, engagement, embodiment, and environment. This article will use a relational ethics framework to examine how nursing leadership can support nurses who care for patients requesting MAID.

Download Full-text

Hospice Palliative Care Volunteers’ Attitudes, Opinions, Experiences, and Perceived Needs for Training Around Medical Assistance in Dying (MAiD)

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909120985130 ◽

2021 ◽

pp. 104990912098513

Author(s):

Stephen Claxton-Oldfield ◽

Sophie Beaudette

Keyword(s):

Palliative Care ◽

End Of Life ◽

Family Members ◽

Mail Survey ◽

Medical Assistance ◽

Perceived Needs ◽

Medical Assistance In Dying ◽

Volunteer Programs ◽

Hospice Palliative Care

Medical assistance in dying (MAiD) has been legal in Canada for over 4 years, but little is known about hospice palliative care (HPC) volunteers’ attitudes toward MAiD. To address this issue, 48 volunteers from 2 HPC volunteer programs in Atlantic Canada completed an anonymous mail survey examining their attitudes, opinions, experiences, and perceived needs for training around MAiD. The volunteers’ responses were generally supportive of MAiD as an end-of-life option and approving of some of the proposed changes to the current MAiD legislation (e.g., 85% of the volunteers either strongly agreed or agreed that advance requests for MAiD should be permitted). In terms of volunteers’ experiences, 15% of the volunteers reported that a patient of theirs had tried to initiate a conversation with them about MAiD. Nearly all (96%) of the volunteers indicated that it was not appropriate for them to bring up the topic of MAiD with their patients or patients’ family members/caregivers. Seventy percent of the volunteers reported that if a patient of theirs chose to pursue MAiD that they would be comfortable with being present (if asked) when it was being administered. Nearly two-thirds (64%) of the volunteers were interested in learning more about MAiD. The implications of this study for volunteer policies, specifically, those policies relating to the role of volunteers when it comes to conversations about MAiD with patients and patients’ family members/caregivers (should they arise) are discussed, as is the need for training on the topic of MAiD.

Download Full-text

Grief and Mourning

10.23943/princeton/9780691193151.003.0005 ◽

2021 ◽

pp. 58-75

Author(s):

John Parker

Keyword(s):

African American ◽

Gender Roles ◽

New World ◽

Dominant Role ◽

The World ◽

Role Of Women ◽

Very High

This chapter considers the most striking aspect of the scene that greeted the young Charles Bannerman, the Gold Coast's first African newspaperman, as he entered his late aunt's house: the dominant role of women in managing the newly dead and in exuberant expressions of grief and rituals of mourning. It discusses the gendered dynamics of grief and mourning and the sensory spectacle of funeral celebrations. The chapter analyzes the startling juxtaposition of grief and gaiety in funeral celebrations, the combination of 'very high spirits' and 'unmistakable signs of grief', that struck Bannerman. Neither of these features was unique to local funerary cultures: distinctions in gender roles with regard to the expression of grief and to scripted mourning rituals have been noted across time in many parts of the world, while revelry has been observed as a characteristic of African American funerals in the slave and post-emancipation societies of the New World. The chapter investigates how gender roles informed grief and mourning among the Akan and their neighbours. It then explains the widely reported combination of intense lamentation and explosive revelry in funeral celebrations.

Download Full-text