Medical assistance in dying and minors-views of the Canadian pediatrician


Medical assistance in dying and minors-views of the Canadian pediatrician


Catena G; Davies D


Paediatrics and Child Health (Canada)




child; female; human; major clinical study; male; controlled study; terminal care; conference abstract; disability; pediatrician; health care system; conversation; intractable pain; medical care; mental disease; terminal disease


BACKGROUND: Medical Assistance in Dying (MAID) has been a heavily debated topic in Canada over the last decade. Since the royal assent of Bill C-14 in 2016, MAID has been available to Canadians 18 years of age or older meeting specific eligibility criteria. As part of this Act, an independent review was initiated to evaluate requests made by mature minors for MAID and ultimately possible inclusion in further iterations of the Act. OBJECTIVE(S): Limited Canadian data is available on the role of MAID in mature minors or the views of health care practitioners on this topic. This study aims to assess the attitudes of Canadian health care practitioners surrounding MAID in minors and their willingness to participate in this process. DESIGN/METHODS: A survey was disseminated to members of the Canadian Paediatric Society, collecting information on attitudes surrounding MAID as it applies to minors, specifically mature minors, those with intolerable disability and mental illness. The survey also assessed the demographics of respondents, including type of practice and patient population. The results were analyzed using logistical regression to determine if there were correlations between practice variables and opinions surrounding MAID. RESULT(S): A 29% response rate was achieved (574/1979), with 487 participants completing all questions. Of the respondents, 46% were in favour that MAID should be eligible for mature minors experiencing progressive or terminal illness or intractable pain; 29% felt patients with intolerable disability should be eligible, while only 8% favoured extension in cases of intolerable mental illness. Lastly, 33% felt that MAID should never be extended to minors. There was no significant correlation between attitudes towards MAID and the respondent's type of practice, or if they work with minors suffering from life-threatening illness. Practitioners who felt their spiritual beliefs guide their opinions surrounding MAID were more likely to oppose eligibility for children (p<0.00001). Practitioners who had the experience of discussing MAID with parents or children were more likely to support extending MAID to mature minors (p=0.046). CONCLUSION(S): There exists a great variability in viewpoints amongst pediatric healthcare practitioners as it relates to extension of MAID to minors. As opinions vary based on factors including spiritual beliefs and conversations pertaining to end of life care, more time and research is warranted to further explore this topic in the context of the Canadian health care system.


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October 2019 List



Catena G; Davies D, “Medical assistance in dying and minors-views of the Canadian pediatrician,” Pediatric Palliative Care Library, accessed May 30, 2024,