A 2015 survey 4 found OT ’ s support for assisted dying varies depending on the client ’ s story . Like other healthcare professionals , we OTs are very reluctant to give up hope that we will find ways of improving our clients ’ experience of and engagement in life .
In cases where the client ’ s condition is life threatening – a terminal diagnosis or degenerative condition – support is high . Where we might still hope for improvement – refractory mental health conditions – we feel uneasy about assisted dying . The problem with hope is that it is not always shared . When I have hope for your life improving , it might help you for some time . At some point , however , my hope might finally fall short of being enough to sustain your hope in the face of ongoing suffering and little real prospect for improvement .
The idea of clients requesting assisted dying should never be a comfortable one . It clearly points to our inability to help enough . That sort of ‘ failure ’ is a dreadful thing for us when we have devoted so much of our lives to developing skills to help people live better . How might an OT respond to such a request ? What does client-centred practice mean in the context of assisted dying ?
In the survey , OTs also shared some thoughts about how they might contribute to this new goal of care . Many OTs said they would not be able to participate at all , while others felt they could offer various supports to clients and family . Many felt a key role would be helping to explore all the options for continued engagement – and who knows better about enabling , adapting and accommodating for diminishing function than OTs ? Many also stated they would be able to contribute to capacity assessments . Where assisted dying does become the client ’ s preferred plan , memory making with family and friends and explaining the whole process were possible roles .
Where we are not able to be involved , how will we communicate this with our core values of respect and trust in mind ? Where we are able , we may be ready to help in some ways , but we may need further training to help competently in others . Practice in providing MAiD will evolve over time – how might we influence it ? Will our clients benefit if we do ? Many OTs think we have much to offer – leading to a better quality end-of-life experience for our clients and their families .
Kevin Reel spoke at the January 2016 Council meeting on the topic of medical assistance in dying . Kevin is an OT who works in the area of ethics .
1 https :// www . coto . org / docs / default-source / defaultdocument-library / interim-guidelines-medicalassistance-in-dying . pdf ? sfvrsn = 2
2 http :// www . health . gov . on . ca / en / news / bulletin / 2015 / docs / eagreport _ 20151214 _ en . pdf
3 http :// jcb . utoronto . ca / news / documents / JCB-PAD- Discussion-Paper-2016 . pdf
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The survey results are soon to be submitted for publication . Interim results are available from : http :// www . caot . ca / conference / 2015 / presentations / t26 . pdf
In July 2016 , the College issued Interim Guidelines for Medical Assistance in Dying . You can find the Guidelines under the Standards & Resources section of www . coto . org .
College of Occupational Therapists of Ontario ON THE RECORD 2016
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