“If Not Me, Then Who?” The Narratives of Medical Aid in Dying (MAiD) Providers and Supporters Around Their Professional Identity and Role in MAiD

Abstract

Medical Assistance in Dying (MAiD) became legally accessible to Canadians in 2016, bringing with it significant changes to the Canadian health care landscape. With legalization of MAiD, physicians, nurses and allied health care workers had to consider their own systems of values, beliefs and their professional identity and decide whether or not they would be able to contribute to this practice or participate actively in this new medical procedure. I argue that health care professionals who participate in this practice create a professional identity that is intrinsically bound to the ethics and practice of MAiD, thus making it permissible for them to support and participate in the procedure actively. Moreover, I argue that this system of morals and beliefs has been accrued by these health care professionals across experiences and time that contribute to their capacity to participate in MAiD. Hamilton Health Sciences (HHS) was the locus for this research. HHS encompasses a network of five hospitals in the Hamilton, Ontario area. Each hospital region in Ontario has a unique staff and values, and HHS is no exception. HHS houses the Assisted Dying Resource and Assessment Service (ADRAS) group, a team of uniquely skilled MAiD providers, assessors and health professionals who service the HHS patient community. It is this group that is at the center of this research. Through interviews with members of ADRAS, I determined that values of altruism, belief in self-determination and deep respect for patients and families are central to the individual and collective identities of this group. In light of this ethical stance, members of ADRAS have crafted complex professional identities both individually and as a collective that enable them to participate in MAiD in a complete and meaningful way.