• J Pain Symptom Manage · Jun 2020

    Review

    The relationship of palliative care with assisted dying where assisted dying is lawful: A systematic scoping review of the literature.

    • Sheri Mila Gerson, Gitte H Koksvik, Naomi Richards, Lars Johan Materstvedt, and David Clark.
    • School of Interdisciplinary Studies, Dumfries Campus, University of Glasgow, Scotland, United Kingdom. Electronic address: sherimila@gmail.com.
    • J Pain Symptom Manage. 2020 Jun 1; 59 (6): 1287-1303.e1.

    ContextA central approach of palliative care has been to provide holistic care for people who are dying, terminally ill, or facing life-limiting illnesses while neither hastening nor postponing death. Assisted dying laws allow eligible individuals to receive medically administered or self-administered medication from a health provider to end their life. The implementation of these laws in a growing number of jurisdictions therefore poses certain challenges for palliative care.ObjectivesTo analyze the research literature about the relationship of assisted dying with palliative care, in countries where it is lawful.MethodsA five-stage scoping review process was adapted from the Joanna Briggs Institute. Data sources searched through October 2018 were MEDLINE, CINAHL, PsychINFO, SCOPUS, and ProQuest dissertations and theses, with additional material identified through hand searching. Research studies of any design were included, but editorials or opinion articles were excluded.ResultsAfter reviewing 5778 references from searches, 105 were subject to full-text review. About 16 studies were included: from Belgium (n = 4), Canada (n = 1), Switzerland (n = 2), and the U.S. (n = 9). We found that the relationship between assisted dying and palliative care practices in these locations took varied and sometimes combined forms: supportive, neutral, coexisting, not mutually exclusive, integrated, synergistic, cooperative, collaborative, opposed, ambivalent, and conflicted.ConclusionThe studies in this review cast only partial light on challenges faced by palliative care when assisted dying is legal. There is pressing need for more research on the involvement of palliative care in the developing practices of assisted dying, across a growing number of jurisdictions.Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

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