In recent years, Medical Assistance in Dying (MAiD) has become a pivotal and contentious component of Canada’s healthcare system. MAiD enables eligible individuals to request assistance in ending their lives, either through self-administration or practitioner-administered means. However, the 2021 amendments to the MAiD legislation, which introduced Track 2 and removed the "reasonably foreseeable death" criterion, have added significant complexity and created new tensions within the healthcare system, particularly among healthcare professionals.
To better understand how healthcare institutions and professionals are adapting to these changes under the new Track 2 amendment, and to explore strategies enabling long-term sustainability of MAiD programs, Professor Samia Chreim has secured two prestigious grants: the Social Sciences and Humanities Research Council Partnership Engage Grant and the Telfer SMRG Research Development Grant. Her project, titled "Managing Tensions and Achieving Sustainability of Medical Assistance in Dying (MAiD) Programs," seeks to address these challenges head-on.
The project partners with the Champlain Regional MAiD Network (CRMN), a network based in The Ottawa Hospital that supports individuals, families, and healthcare providers with information and resources on MAiD. CRMN links healthcare organizations across the Ottawa region to provide standardized education, clinical care, and program oversight. Their mission is to deliver a seamless experience for both patients and healthcare providers through an integrated service model, with a focus on high-quality, patient-centered care. Through this collaboration, Chreim aims to explore how tensions surrounding MAiD can be effectively managed and how the sustainability of these programs can be enabled. The research will aim to improve decision-making processes, bolster support systems, optimize resources, and safeguard the well-being of healthcare professionals involved in MAiD.
The study will focus on the rapid transformation of professional roles resulting from MAiD legislation. Unlike gradual shifts commonly seen in healthcare, MAiD legislation has forced swift adaptations and has created tensions for professionals, especially given the emotional and moral weight of the work. Introduction of MAiD legislation also led to the creation of a new role in healthcare setting - that of MAiD program coordinator - intended to manage the complexity of the process, yet this role lacks clear structural guidelines, adding another layer of difficulty. This project will explore the challenges of collective leadership and professional role reconfiguration in this emotionally charged and evolving field. The findings will contribute valuable insights into leadership models, role dynamics, and tension management in healthcare settings.
Chreim says, “I have an interest in professional roles and practices and in how they evolve over time. I am also interested in leadership dynamics and have studied this topic in various organizational contexts, including health care. This research study offers the opportunity to pursue both topics in a complex and quickly evolving context.
The research will employ a qualitative case study methodology, utilizing interviews, observations, and document analysis to investigate MAiD practices across urban and rural healthcare settings. Semi-structured interviews will be conducted with healthcare professionals and leaders involved in MAiD. The research team will also observe MAiD-related meetings and analyze relevant documents. Thematic analysis will be used to examine the data, enabling comparisons across diverse healthcare environments to inform both academic research and practical improvements in the field.
Ultimately, this research aims to provide actionable insights into the challenges and opportunities within MAiD services, offering strategies for managing tensions and enabling the long-term sustainability of high-quality care. The findings will benefit healthcare practitioners, policymakers, and academics, with dissemination through webinars, conference presentations, and media briefings, ensuring broad accessibility to various audiences.
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