Medical Assistance in Dying (MAID) was legalized in Canada in 2016. In 2021, an update in legislation included changes to MAID eligibility and procedural safeguards. Guided by the Ottawa Decision Support Framework (ODSF), the overall aim was to describe how Canadian patients considering MAID are being supported in making the decision about end-of-life care. Eleven articles were included in the literature review. ODSF themes are evident in MAID literature. Nurses play key roles in end-of-life decision-making. Environmental scan of publicly available MAID resources identified 58 eligible resources. Sixty-nine percent of MAID resources were updated with 2021 legislation. None met the International Patient Decision Aid Standards criteria. Thirty met Patient Education Materials Assessment standard for adequate understandability and 11 for actionability. Although patient decision aids are effective for supporting health care decisions, none exist for MAID and current resources are inadequate for supporting people of lower health literacy.

Purpose: To synthesize evidence on decisional needs assessments and patient decision aid (PtDA) trials based on the Ottawa Decision Support Framework (ODSF) in order to validate the concepts and test the main assertion in the ODSF. Decisional Needs: The systematic review studies (n=45) validated all of the decisional needs identified in the ODSF. Nine new manifestations of ODSF decisional needs emerged (e.g. information overload, unreceptive to information/deliberation, relationship barriers with practitioner). PtDAs: The sub-analysis identified 24 ODSF PtDA trials. Compared to usual care, ODSF PtDAs improved decision quality, addressed decisional needs and reduced decision delay. Further evaluation is needed on downstream impacts of these improvements on decision-making. Conclusions: Using Walker and Avant’s theory testing steps, the integrated findings from the systematic review and sub-analysis validated the ODSF decisional needs concepts and tested the main assertion in the ODSF (that PtDAs address decisional needs and improve decision quality).

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