Oral medical assistance in dying (MAiD): informing practice to enhance utilization in Canada
| Autor: | Viren N. Naik, Konia Trouton, Donna K Buna, Alan Chaput, Christopher Harty |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Canada Pain medicine MEDLINE Administration Oral Legislation Self Administration Suicide Assisted 03 medical and health sciences 0302 clinical medicine Anesthesiology medicine Humans 030212 general & internal medicine Medical prescription Assisted suicide Intensive care medicine Terminal Care 030505 public health business.industry Euthanasia General Medicine Quality of evidence Anesthesiology and Pain Medicine Pharmaceutical Preparations Anesthesia 0305 other medical science business |
| Zdroj: | Canadian journal of anaesthesia = Journal canadien d'anesthesie. 66(9) |
| ISSN: | 1496-8975 |
| Popis: | The legislation Bill C-14 legalized medical assistance in dying (MAiD) in Canada. After thorough assessments of eligibility by two clinicians, Bill C-14 allows for both intravenous-assisted death by a clinician (euthanasia) and prescription of oral medication for self-administration (assisted suicide). Nevertheless, since inception in June 2016, intravenous euthanasia is the main form of delivery of assisted death in Canada. The reasons why oral MAiD is underutilized in Canada are multifactorial. Currently, there is no consensus on either the medications or the protocols for oral administration, nor a comprehensive understanding of the potential side effects and complications associated with different regimens. The quality of evidence for optimal MAiD medications is low, so any suggested recommendations can only be informed by the global but generally anecdotal experience. The challenges for implementing oral MAiD in Canada include a need to enhance clinician comfort in prescribing oral medications as an alternative to intravenous administration. The goals for ideal oral MAiD medications are 100% effectiveness and minimal side effects, while ensuring that the needed dose is both palatable and deliverable in a tolerable oral volume. The Netherlands has the most experience worldwide and barbiturates have emerged as the most common, efficacious, and tolerable agents by patients. Based on this global experience and the over-arching goals for oral MAiD, we recommend the use of a secobarbital suspension combined with antiemetic prophylaxis. |
| Databáze: | OpenAIRE |
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