Understanding the Factors Explaining the Growing Use of Medical Assistance in Dying in Québec: Protocol for an Interdisciplinary Mixed Methods and Multimethods Study.
| Title: | Understanding the Factors Explaining the Growing Use of Medical Assistance in Dying in Québec: Protocol for an Interdisciplinary Mixed Methods and Multimethods Study. |
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| Authors: | Bouthillier MÈ; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.; Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.; Marcoux I; Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.; Perron C; School of Social Work, Faculty of Arts and Humanities, Université de Sherbrooke, Sherbrooke, QC, Canada.; Gagnon B; Department of Family Medicine and Emergency Medicine, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada.; VITAM Sustainable Health Research Center, Université Laval, Québec, QC, Canada.; Lussier D; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.; Rouly G; Research Centre, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.; Moreau M; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.; Dorval M; Faculty of Pharmacy, Université Laval, Québec, QC, Canada.; Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada.; Lessard S; Department of Anthropology, Faculty of Arts and Sciences, Université de Montréal, Montréal, QC, Canada.; Centre for Research and Expertise in Social Gerontology, Montréal, QC, Canada.; Girard D; Department of Health Sciences, Université du Québec à Rimouski, Rimouski, QC, Canada.; Bravo G; Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.; Hébert M; Department of Nursing, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.; Giroux M; Civil Law Section, Law Faculty, University of Ottawa, Ottawa, ON, Canada.; Lemyre S; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.; Beaudin A; Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.; Bourque CJ; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.; Centre de recherche en pédagogie de la santé, Faculté de médecine, Université de Montréal, Montréal, QC, Canada.; Soulières M; School of Social Work, Université de Montréal, Montréal, QC, Canada.; Lévesque M; Centre for Research and Expertise in Social Gerontology, Montréal, QC, Canada.; School of Social Work, Université du Québec à Montréal, Montréal, QC, Canada.; Gupta M; Department of Psychiatry and Addiction Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.; Bourgeois-Guérin V; Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada.; Lavoie D; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.; Lavoie B; Law Faculty, Université de Sherbrooke, Sherbrooke, QC, Canada.; Plaisance A; Qulysis, Québec, QC, Canada.; Bernier L; Law Faculty, Université de Sherbrooke, Sherbrooke, QC, Canada.; Dupuis J; Centre Integre de Sante et de Services Sociaux de Laval, Laval, QC, Canada. |
| Source: | JMIR research protocols [JMIR Res Protoc] 2026 Apr 20; Vol. 15, pp. e83549. Date of Electronic Publication: 2026 Apr 20. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: JMIR Publications Country of Publication: Canada NLM ID: 101599504 Publication Model: Electronic Cited Medium: Internet ISSN: 1929-0748 (Electronic) Linking ISSN: 19290748 NLM ISO Abbreviation: JMIR Res Protoc Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Toronto : JMIR Publications |
| MeSH Terms: | Suicide, Assisted*/legislation & jurisprudence ; Suicide, Assisted*/statistics & numerical data ; Suicide, Assisted*/trends; Quebec ; Humans ; Research Design ; Terminal Care |
| Abstract: | Background: Medical assistance in dying (MAiD) became a legal end-of-life option on December 10, 2015, in Québec, and on June 17, 2016, in the rest of Canada. Since its legalization, there has been a steady increase in the number of MAiD requests and provisions. Across permissive jurisdictions, Québec now has the highest rate of assisted death. Despite the growing use of MAiD, research examining the factors driving this increase remains limited and fragmented. Existing studies offer partial and sometimes contradictory explanations, with little integration of legal, institutional, societal, and individual dimensions. Further research is needed to better understand the determinants of MAiD requests and practices, particularly in the Canadian and Québec contexts.; Objective: This research aims to understand the factors influencing changes in MAiD requests and administrations in Québec by examining laws, practices, societal perspectives, organization of care and services, and individual characteristics of those requesting MAiD, as well as their interrelationships. We present the protocol developed by the Consortium interdisciplinaire de recherche sur l'aide médicale à mourir, an interdisciplinary research consortium, including an international advisory committee, set up for this research.; Methods: The design of this protocol is multimethods and convergent mixed methods, including (1) an international cross-thematical approach with 4 main research methods (a scoping review, key informant interviews, focus groups with health care professionals, and a population-based survey) chosen to partially answer research questions across the entire study and to compare with other jurisdictions and (2) 11 theme-specific methods (including community forums, media coverage analysis, comparative legal analyses, case studies of triads, individual interviews, and system mapping) to enrich and complement findings from the cross-thematical approach.; Results: When this 3-year funded study started in July 2024, several research methods not requiring ethics committee approval (because no human participants were involved) were initiated, including scoping and systematic reviews, media coverage analysis, and comparative legal analyses. By August 2025, interviews with key informants were completed, and analyses took place in September. Concurrently, other subteams started data collection (focus groups December 2025) or are getting ready to seek ethics approval for their protocols and data collection processes involving human participants: case studies of triads, individual interviews, and community forums.; Conclusions: Findings from the international cross-thematical approach and theme-specific methods will provide a comprehensive understanding of the factors influencing the use of MAiD in Québec. This study has strengths, including the use of a specific theoretical framework, a variety of complementary methods, and an integrated knowledge mobilization strategy. As for its limitations, we foresee challenges with the comparison of jurisdictions in terms of language, culture, and legal systems, as well as access to data about MAiD cases, since reporting systems may differ between jurisdictions.; International Registered Report Identifier (irrid): DERR1-10.2196/83549.; (©Marie-Ève Bouthillier, Isabelle Marcoux, Catherine Perron, Bruno Gagnon, David Lussier, Ghislaine Rouly, Mathieu Moreau, Michel Dorval, Sabrina Lessard, Dominique Girard, Gina Bravo, Maude Hébert, Michelle Giroux, Simon Lemyre, Alexandra Beaudin, Claude Julie Bourque, Maryse Soulières, Maude Lévesque, Mona Gupta, Valérie Bourgeois-Guérin, David Lavoie, Bertrand Lavoie, Ariane Plaisance, Louise Bernier, Jacinthe Dupuis. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 20.04.2026.) |
| Contributed Indexing: | Keywords: Canada; Québec; assisted dying related factors; end-of-life care; euthanasia; evolution of assisted dying practices; factors explaining use of MAiD; growing use of MAiD; medical assistance in dying; mixed and multimethod study; protocol |
| Entry Date(s): | Date Created: 20260430 Date Completed: 20260430 Latest Revision: 20260507 |
| Update Code: | 20260507 |
| PubMed Central ID: | PMC13139836 |
| DOI: | 10.2196/83549 |
| PMID: | 42061866 |
| Database: | MEDLINE |
Journal Article