BACKGROUND Medical Assistance in Dying (MAID) in Canada came into effect in 2016 with the passing of Bill C-14. As patient interest and requests for MAID continue to evolve in Canada, it is important to understand the attitudes of future providers and the factors that may influence their participation. Attitudes towards physician hastened death (PHD) in general and the specific provision of MAID (e.g., causing death by lethal prescription or injection) are unknown among Canadian residents. This study examined residents' attitudes towards PHD and MAID, and identified factors (e.g., demographics, clinical exposure to death and dying) that may influence their decision to participate in PHD and provide MAID. METHODS A cross-sectional survey was adapted from prior established surveys on MAID to reflect the Canadian setting. All Canadian family medicine programs were invited to participate. The survey was distributed between December 2016 and April 2017. Analysis of the results included descriptive statistics to characterize the survey participants and multivariable logistic regressions to identify factors that may influence residents' attitudes towards PHD and MAID. RESULTS Overall, 247 residents from 6 family medicine training programs in Canada participated (response rate of 27%). While residents were most willing to participate in treatment withdrawal (52%), active participation in PHD (41%) and MAID by prescription of a lethal drug (31%) and lethal injection (24%) were less acceptable. Logistic regressions identified religion as a consistent and significant factor impacting residents' willingness to participate in PHD and MAID. Residents who were not strictly practicing a religion were more likely to be willing to participate in PHD (OR = 17.38, p < 0.001) and MAID (lethal drug OR = 10.55, p < 0.01, lethal injection OR = 8.54, p < 0.05). Increased clinical exposure to death and dying crudely correlated with increased willingness to participate in PHD and MAID, but when examined in multivariable models, only a few activities (e.g., declaring death, completing a death certificate) had a statistically significant association. Other significant factors included the residents' sex and location of training. CONCLUSIONS Residents are hesitant to provide MAID themselves, with religious faith being a major factor impacting their decision.

中文翻译：

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评估加拿大家庭医学居民对医疗辅助死亡的态度：一项横断面研究。

背景技术随着C-14法案的通过，加拿大的濒死医疗援助（MAID）于2016年生效。随着患者的兴趣和对MAID的要求在加拿大不断发展，了解未来服务提供者的态度以及可能影响其参与的因素非常重要。总体上，对医生催促死亡（PHD）的态度和MAID的具体规定（例如，通过致命的处方或注射引起死亡）在加拿大居民中尚不清楚。这项研究检查了居民对PHD和MAID的态度，并确定了可能影响其参与PHD和提供MAID决定的因素（例如，人口统计学，临床接触死亡和死亡）。方法横断面调查改编自先前建立的MAID调查，以反映加拿大的环境。所有加拿大家庭医学计划均应邀参加。该调查于2016年12月至2017年4月期间进行。结果分析包括描述性统计数据以表征调查参与者的特征，以及多变量logistic回归以识别可能影响居民对PHD和MAID态度的因素。结果总体而言，加拿大6个家庭医学培训项目的247位居民参加了调查（回复率为27％）。尽管居民最愿意参加戒断治疗（52％），但接受处方药（31％）和注射剂（24％）的积极参与PHD（41％）和MAID的积极性较差。Logistic回归确定宗教是影响居民参与PHD和MAID意愿的一个持续且重要的因素。未严格遵守宗教信仰的居民更愿意参加PHD（OR = 17.38，p <0.001）和MAID（致命药物OR = 10.55，p <0.01，致命注射OR = 8.54，p <0.05） 。死亡和临终死亡的临床暴露增加与参与PHD和MAID的意愿增加密切相关，但是在多变量模型中进行检查时，只有少数活动（例如，宣布死亡，完成死亡证明）具有统计学上的显着关联。其他重要因素包括居民的性别和受训地点。结论居民不愿自己提供MAID，宗教信仰是影响其决定的主要因素。001）和MAID（致死性药物OR = 10.55，p <0.01，致死性注射OR = 8.54，p <0.05）。死亡和临终死亡的临床暴露增加与参与PHD和MAID的意愿增加密切相关，但是在多变量模型中进行检查时，只有少数活动（例如，宣布死亡，完成死亡证明）具有统计学上的显着关联。其他重要因素包括居民的性别和受训地点。结论居民不愿自己提供MAID，宗教信仰是影响其决定的主要因素。001）和MAID（致死性药物OR = 10.55，p <0.01，致死性注射OR = 8.54，p <0.05）。死亡和临终死亡的临床暴露增加与参与PHD和MAID的意愿增加密切相关，但是在多变量模型中进行检查时，只有少数活动（例如，宣布死亡，完成死亡证明）具有统计学上的显着关联。其他重要因素包括居民的性别和受训地点。结论居民不愿自己提供MAID，宗教信仰是影响其决定的主要因素。（例如，宣布死亡，填写死亡证明）具有统计学上的显着关联。其他重要因素包括居民的性别和受训地点。结论居民不愿自己提供MAID，宗教信仰是影响其决定的主要因素。（例如，宣布死亡，填写死亡证明）具有统计学上的显着关联。其他重要因素包括居民的性别和受训地点。结论居民不愿自己提供MAID，宗教信仰是影响其决定的主要因素。