Literature Review

Montana House considers bill to put more sideboards on medical assistance in dying NBC KPVI-6, Pocatello, ID; by Darrell Ehrlick; 2/26/25 ... On Wednesday, in a hearing of the House Judiciary Committee that was full of as much testimony as tears, opponents and supporters of medical aid in dying, sometimes called “physician-assisted suicide,” discussed House Bill 637, which would codify requirements for physicians to use the process. ... Demonstrating the often complex political issue that can’t be broken down by party lines, Rep. Ed Stafman, D-Bozeman, who is also a lawyer and rabbi, said he was truly conflicted on the bill, and wondered how Juras, also an attorney, viewed the proposed legislation in light of the state constitution’s right to dignity. ... Testimony from medical professionals ranged from strong support to opposition,  ... [Click here for] Here's what [Montana] House Bill 637 would do ...

‘End-of-Life Options Act’ moving forward The Famuan - Florida A& M University; by Myah Canidate; 2/22/25 In a world where medical advancements have extended life, the question of how we choose to end it has become increasingly pertinent. House Bill 471, commonly known as the Florida End-of-Life Options Act,  proposes a significant shift in how terminally ill patients can approach their final days. This legislation would allow qualified individuals the right to request medication to end their lives peacefully, igniting a complex debate around autonomy, ethics and healthcare practices. ... Supporters of HB 471 argue that it offers a compassionate choice for those enduring unbearable suffering. ... Critics argue that vulnerable patients may feel pressure to choose this option, particularly in situations involving financial strain or family dynamics. 

End-of-life-care option bill in New Hampshire stirs conversation on deathMonadnock Ledger-Transcript, Peterborough, NH; by Sruthi Gopalakrishnan; 2/4/25 At age 75, Rep Bob Lynn says he loves life. But he knows he’s no “spring chicken” and his days are finite. The former chief justice of the state Supreme Court is the prime sponsor of House Bill 254, known as “The New Hampshire End of Life Freedom Act,” which gives terminally ill adults the choice to take control of their final days and end their own life with a dose of lethal medication. ... If the legislation passes, terminally ill individuals aged 18 and over with a prognosis of less than six months to live will be able to receive medications to end their lives on their own terms. It comes with a long list of requirements that two health care providers must verify, including that they have healthy mental capacity, are aware of alternative options and are competent to self-administer the drugs. Opponents warned it could encourage suicide, be misused and send a harmful message that people with disabilities are a burden. ... Michelle Flynn, a retired internal medicine physician from Bedford, said allowing terminally ill patients to end their lives opens the door to death as a treatment option. ... Lisa Beaudoin of Temple, founder of Strategies for Disability Equity, worries it would worsen the discrimination disabled people already face in health care. 

What the experiences of young persons can teach us about medical aid in dying for psychiatric illnessJAMA Psychiatry; Brent Kious, MD, PhD; 1/25Medical aid in dying (MAID) is becoming ever more available. While it is most often used by persons with terminal illnesses, it is also becoming more accessible to those with a primary psychiatric illness. Some countries, including the Netherlands, have long allowed MAID for persons experiencing unbearable and irremediable suffering due to a mental illness. In Canada, Quebec’s Superior Court ruled in 2019 that restricting MAID to persons with a “reasonable foreseeable natural death” violates key sections of the Canadian Charter, implying that MAID must be made available to persons with nonterminal conditions, including psychiatric illness. Meanwhile, while only persons with terminal illness can access MAID in those parts of the US that have legalized it, some physicians have argued that certain psychiatric illnesses, especially anorexia nervosa, can be terminal, opening the door to MAID for persons with a primary psychiatric illness. 

We studied 20 places around the world and found the most common diseases linked with voluntary assisted dying Medical Xpress; by Eliana Close and James Downar, The Conversation; 12/18/24 As of 2023, 282 million people lived in regions where voluntary assisted dying is legal. Jurisdictions such as the Netherlands, Belgium and Oregon have had these laws in place for decades. Other countries, including Canada, Spain, New Zealand and Australia, have passed reforms more recently. ... Debates about voluntary assisted dying are often highly polarized. Understanding the factors driving assisted dying is essential for evidence-based debates and for improving care for people with serious conditions. In a recent study, we examined data from people accessing voluntary assisted dying in 20 jurisdictions around the world. In particular we looked at what diseases they had. ...  With an international team of researchers, we looked at the role disease plays in voluntary assisted dying. We analyzed publicly available data from 20 jurisdictions in eight countries between 1999 and 2023. Overall, most people who accessed voluntary assisted dying had cancer (66.5% of cases). Neurological diseases were the second most common (8.1%), followed by heart (6.8%) and lung (4.9%) conditions. 

Contextualizing attitudes toward medical aid in dying in a national sample of interdisciplinary US hospice clinicians: hospice philosophy of care, patient-centered care, and professional exposurePalliative Care and Social Practice; Todd D Becker, John G Cagle, Cindy L Cain, Joan K Davitt, Nancy Kusmaul, Paul Sacco; 12/24Findings suggest that contextual factors-namely, the environments in which hospice clinicians practice-may shape attitudes toward MAID [medical aid in dying]. Unanticipated results indicating that hospice professionals' adherence to hospice values was not significantly associated with attitudes toward MAID underscore the need for further research on these complex associations, given previous theoretical and empirical support.

Willingness to be present throughout patient death via medical aid in dying in a national sample of interdisciplinary US hospice clinicians: a content analysis of rationalesPalliative Care and Social Practice; Todd D. Becker, Cindy L. Cain, John G. Cagle, Joan K. Davitt, Nancy Kusmaul, Paul Sacco; 10/24 The United States is one of a growing number of countries across Europe, North America, Oceania, and South America to have legalized what, domestically, is referred to as medical aid in dying (MAID). The objective of the current study was to explore attitudes toward presence throughout a patient’s death via MAID in hospice physicians, nurses, social workers, and chaplains. Participants who were willing to be present (n = 305 [74%]) attributed their willingness to personal support, definitions of quality clinical care, and values from their professional training. Those who were unwilling (n = 63 [15%]) noted personal objections to the concept of MAID, personal objections to MAID participation, and perceptions of MAID’s misalignment with healthcare. Hospice clinicians would benefit from greater professional guidance and support pertaining to MAID.

MAiD in America: A rapid review of medical assistance in dying in the United States and its implications for practice for health care professionalsJournal of Hospice and Palliative Nursing; by Kathy Howard Grubbs, Christiana M. Keinath, Sharon E. Bigger; 10/24The evolving legal landscape associated with medical assistance in dying (MAiD) may pose significant challenges for hospice and palliative care professionals. In the United States, 10 states and 1 jurisdiction have passed legislation allowing MAiD. National organizations, such as the Hospice and Palliative Nurses Association, have created position statements to serve as guides to care. Given the clinical and ethical challenges associated with MAiD, a rapid review was conducted to provide current evidence for policymakers, health care professionals, and researchers to use when considering care management and policy initiatives. Using a systematic approach, publications related to MAiD between 2019 and 2024were extracted and synthesized. The review provides definitions of terms that differentiate between MAiD, euthanasia, physician-assisted suicide, medically assisted death of the nonterminal patient, and death with dignity. A total of 23 articles were included in the review and categorized into 4 themes: (1) legal, regulatory, and policy concerns; (2) health care professional experience of MAiD; (3) patient and caregiver experience of and communication about MAiD; and (4) disparate access to MAiD.

A moral code: Ethical dilemmas in medicine — three physicians face crossroads in patient care MedPage Today; podcast by Genevieve Friedman, Perspectives Editor; 10/25/24 We are back for another episode of our medical podcast, which we hope isn't really a podcast about medicine, but a podcast about life, death, dilemma, the challenges, and sometimes the joys of medicine. ... Now, medicine is complicated because a lot of times there aren't hard and fast rules ... One treatment isn't always right or wrong for someone. One surgery isn't always successful or unsuccessful, and one diagnosis isn't always correct. Decisions aren't black and white, they're varying shades of gray. So we come up with principles to help handle this -- codes if you will. But even those get a bit marred by complexity at times. As you'll hear in this episode of Anamnesis with the theme of "A Moral Code: Ethical Dilemmas in Medicine," one of our biggest codes is "do no harm." But what is harm? Who decides what harm is, what happens if we disagree?

Hospice policy mandating two-week enrollment prior to ingesting aid-in-dying medicationAcademy of Aid-in-Dying Medicine; by Constance Holden, Jeanne Kerwin, Paula Goodman-Crews, Margaret Pabst Battin; 10/2/24[A white paper from the ACAMAID Ethics Consultation Service.] An aid-in-dying-prescribing physician is concerned about a policy that several local hospices have implemented prohibiting patients from ingesting their aid-in-dying medication during the first two weeks of enrollment. The requesting provider is concerned that this policy requires patients who have made aid-in-dying requests to wait well beyond the 48 hours mandated by law. This potentially results in undue added suffering for the patient. It is also a potentially discriminatory practice, as it leads to unequal access to care.

You cannot come to New Jersey to die, judge says New Jersey 101.5; by Eric Scott; 9/20/24 Terminally ill individuals may not travel to New Jersey to end their lives. When New Jersey's Aid in Dying law took effect in 2019, it included a provision that doctors verify a patient's residency before prescribing them medications that will end their lives. A federal judge has ruled the residency requirement does not violate the U.S. Constitution. The ruling came after terminally ill cancer patients from Delaware and Pennsylvania sued. They wanted to travel to New Jersey to end their lives. ...

[Australia] Maybe for unbearable suffering: Diverse racial, ethnic and cultural perspectives of assisted dying. A scoping reviewPalliative Medicine; Melissa J Bloomer, Laurie Saffer, Jayne Hewitt, Lise Johns, Donna McAuliffe, Ann Bonner; 8/24Perspectives on assisted dying are dynamic and evolving. Even where assisted dying is legalised, individual's cultural attributes contribute to unique perspectives of assisted dying as an end-of-life option. Thus, understanding a person's culture, beliefs, expectations and choices in illness, treatment goals and care is fundamental, extending beyond what may be already considered as part of clinician-patient care relationships and routine advance care planning.

Assisted dying bill introduced in Parliament BBC News; 7/26/24 A bill which would allow terminally ill adults with six months or fewer to live to get medical help to end their own lives has been introduced in the House of Lords, by former Labour Justice Secretary Lord Falconer. He told the BBC his bill would apply only to people "mentally able to make the decision." Their choice would also need to be approved by two doctors and the high court. Private members' bills introduced in the Lords rarely become law. However, Lord Falconer says he hopes a backbench MP will introduce a similar bill in the Commons, where it will have a greater chance of success.