Hospital Pharmacists' Experience with Medical Assistance in Dying
Bibliographic record
Abstract
Background: Pharmacists have been involved in medical assistance in dying (MAiD) practice in Canada since 2016 and in various international jurisdictions for over two decades. Despite their involvement, little is known about pharmacists’ actual experiences with MAiD. The experiences of pharmacists whose practice already encompasses MAiD will contribute to understanding pharmacists’ roles and supporting others in adopting this practice in other countries.Objective: To investigate pharmacists’ experiences with MAiD practice in the hospital setting.Methods: Semi-structured interviews were conducted with pharmacists that had cared for patients seeking MAiD. The interviews were digitally recorded and transcribed verbatim. A framework analysis approach was used to analyze data. Analysis included coding of data and identification of themes through an iterative process involving constant comparison. Data were managed and stored using Quirkos and Microsoft Excel software.Results: A total of 19 hospital pharmacists representing a range of practice experience and settings in Alberta participated in the study between June 2019 and October 2020. Three themes illuminated participants’ experiences with MAiD: 1) finding a place, 2) serving in a patient-centred role, and 3) bearing emotional burdens. Several considerations influenced pharmacists’ decisions to participate in MAiD. The role focused on medication supply and documentation, yet it was experienced as a caring, patient-centred role. Opportunities to expand involvement beyond the medication-related responsibilities were welcomed by some participants. The experiences were associated with a range of emotions, both positive and negative. Partici-pants described supports and actions taken to ease emotional burdens. Conclusions: The results of this study will inform pharmacists, including those who are contemplating participation in MAiD practice, about the range of experiences associated with assisted dying practice. Pharmacy leaders may apply these results to further support pharmacists and expand pharmacists’ roles in MAiD.Declaration: Theresa J Schindel received funding from the CSHP Foundation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.016 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.005 | 0.003 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.006 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".