학술논문

Medical Assistance in Dying in Oncology Patients: A Canadian Academic Hospital’s Experience
Document Type
article
Source
Current Oncology, Vol 29, Iss 12, Pp 9407-9415 (2022)
Subject
medical assistance in dying
euthanasia
end-of-life care
palliation
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Language
English
ISSN
1718-7729
1198-0052
Abstract
Background: Medical assistance in dying (MAID) was legislatively enacted in Canada in June 2016. Most studies of patients who received MAID grouped patients with cancer and non-cancer diagnoses. Our goal was to analyze the characteristics of oncology patients who received MAID in a Canadian tertiary care hospital. Methods: We conducted a retrospective review of all patients with cancer who received MAID between June 2016 and July 2020 at London Health Sciences Centre (LHSC). We describe patients’ demographics, oncologic characteristics, symptoms, treatments, and palliative care involvement. Results: Ninety-two oncology patients received MAID. The median age was 72. The leading cancer diagnoses among these patients were lung, colorectal, and pancreatic. At the time of MAID request, 68% of patients had metastatic disease. Most patients (90%) had ECOG performance status of 3 or 4 before receiving MAID. Ninety-nine percent of patients had distressing symptoms at time of MAID request, most commonly pain. One-third of patients with metastatic or recurrent cancer received early palliative care. The median time interval between the first MAID assessment and receipt of MAID was 7 days. Interpretation: Most oncology patients who received MAID at LHSC had poor performance status and almost all had distressing symptoms. The median time interval between first MAID assessment and receipt of MAID was shorter than expected. Only one-third of patients with metastatic or recurrent cancer received early palliative care. Improving access to early palliative care is a priority in patients with advanced cancer. Study registration: We received research approval from Western University’s Research Ethics Board (REB) with project ID number 115367, and from Lawson’s Research Database Application (ReDA) with study ID number 9579.