Univer­sity of Leth­bridge re­searchers lead team ex­am­in­ing is­sues re­lated to med­i­cally as­sisted dy­ing in ru­ral Al­berta

Prairie Post (West Edition) - - Bargaineer -

What are your thoughts on med­i­cally as­sisted dy­ing? What do you sup­pose shaped those opin­ions? How much might your lo­ca­tion im­pact your ex­pe­ri­ence with the prac­tice? These are the types of ques­tions a Univer­sity of Leth­bridge re­searcher and her team will be ex­am­in­ing over the next two years.

Since the fed­eral gov­ern­ment le­gal­ized Med­i­cal As­sis­tance in Dy­ing (MAiD) in 2016, lit­tle re­search has been done on how the new law is af­fect­ing those in ru­ral com­mu­ni­ties. Data from Al­berta Health

Ser­vices sug­gests there are dif­fer­ences in knowl­edge and at­ti­tudes about MAiD be­tween ur­ban and ru­ral com­mu­ni­ties, but these dif­fer­ences have yet to be ex­plored. Dr. Ju­lia Brassolott­o and a team of re­searchers have re­ceived a So­cial Sciences and Hu­man­i­ties Re­search Coun­cil of Canada (SSHRC) In­sight De­vel­op­ment Grant to ex­am­ine eth­i­cal and pol­icy is­sues re­lated to MAiD in ru­ral Al­berta.

The project re­ceived fund­ing in July and is cur­rently in the ethics ap­proval stage, af­ter which Brassolott­o and her group, which con­sists of Drs. Monique Sedg­wick (Fac­ulty of Health Sciences, Univer­sity of Leth­bridge), Duff War­ing (phi­los­o­phy, York Univer­sity), and Sally Chivers (cul­tural stud­ies, Trent Univer­sity), will be­gin their ex­am­i­na­tion of the is­sues re­lated to MAiD from var­i­ous an­gles.

“Our goal is to bet­ter un­der­stand MAiD in ru­ral Al­berta,” says Brassolott­o, an as­sis­tant pro­fes­sor in the Fac­ulty of Health Sciences’ Pub­lic Health pro­gram and the Al­berta In­no­vates Re­search Chair in Ru­ral Health and Well-be­ing. “We want to un­der­stand how cur­rent poli­cies af­fect ru­ral com­mu­ni­ties and gain in­sight into peo­ple’s lived ex­pe­ri­ences of re­lated eth­i­cal is­sues.”

Brassolott­o sits on the Al­berta Health Ser­vices South Zone Ethics Com­mit­tee and a con­ver­sa­tion at a meet­ing in 2019 iden­ti­fied some un­ex­plored dif­fer­ences in ru­ral com­mu­ni­ties. This got her think­ing about the short­age of physi­cians in ru­ral set­tings and the lim­ited ac­cess to pal­lia­tive care. Some peo­ple have wor­ried that MAiD could present eth­i­cal is­sues spe­cific to ru­ral set­tings. For ex­am­ple, there may be stigma as­so­ci­ated with pro­vid­ing or re­quest­ing the prac­tice, lim­ited pri­vacy, or over­laps be­tween per­sonal and pro­fes­sional re­la­tion­ships that com­pli­cate de­ci­sion-mak­ing.

Brassolott­o and her team want to dig deeper and gain a clear un­der­stand­ing of the lo­cal pol­icy land­scape and the in­flu­ences that have helped shape peo­ple’s views.

“We wanted to ex­plore this is­sue from a so­cial sciences and hu­man­i­ties per­spec­tive, and ask ques­tions like, “Are your de­ci­sions made fully on your own when you are in this com­plex web of re­la­tion­ships in a small com­mu­nity, for bet­ter and for worse?”” she says. “We want to get away from stereo­types or as­sump­tions about what ru­ral residents think. We want to de­velop a rich un­der­stand­ing of peo­ple’s con­cerns, what’s work­ing well, and what needs work.”

One of the in­ter­est­ing av­enues they will ex­plore is the role pop­u­lar me­dia has played in shap­ing peo­ples’ ideas of MAiD. Draw­ing from cul­tural stud­ies, the group will con­duct a content scan of MAiD in re­gional and more wide­spread me­dia. How the prac­tice is dis­cussed in news sto­ries, film and lit­er­a­ture can shape pub­lic per­cep­tion in ur­ban and ru­ral set­tings.

The re­search team in­volves both un­der­grad­u­ate and grad­u­ate stu­dents in data col­lec­tion and anal­y­sis, with the group look­ing to be­gin in­ter­views with ru­ral residents and health-care providers early next year. They ex­pect to speak with 25 to 30 peo­ple in all. The team’s aim is to add to the body of knowl­edge about MAiD by giv­ing it some ru­ral con­text.

“In terms of change that we’re try­ing to make, I’d like to see more con­text-spe­cific poli­cies and prac­tices,” she says. “We can’t nec­es­sar­ily have a blan­ket pol­icy for all of Al­berta and as­sume it will play out the same in Cal­gary as it does in Bas­sano or Milk River, for ex­am­ple.”

Brassolott­o is ex­cited about the blend of so­cial science and hu­man­i­ties ap­proaches and be­lieves the project will ben­e­fit from the in­volve­ment of a bioethi­cist, a nurse, a pol­icy ex­pert, and a cul­tural stud­ies pro­fes­sor on the project.

DR. JU­LIA BRASSOLOTT­O

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