Medical Assistance in Dying (MAID) Survey
Study Title: “MAID in Canada”: The Canadian Psychological Association (CPA) Members Survey on Medical Assistance in Dying (MAID)
Principal Investigator on behalf of the CPA Working Group:  Marnin J. Heisel, Ph.D., C.Psych., Western University
Keith Wilson, Ph.D., C.Psych.
Paulette Hunter, Ph.D., C.Psych., The University of Saskatchewan
Sam Mikail, Ph.D., C.Psych.
Joseph Pellizzari, Ph.D., C.Psych.
Kathleen Bailey, M.A.
Research Assistants:
Belal Zia, B.Sc., Lawson Health Research Institute
Ben Peckham, M.Sc., Lawson Health Research Institute
This letter outlines a research study in order to provide you with all information you need to decide whether you would like to participate in it or not.  We are inviting your voluntary participation in this study because you are a member of the Canadian Psychological Association (CPA) and/or a member of provincial psychological association.
On June 17, 2016, Bill C-14 received royal assent, effectively overturning the law prohibiting the provision of advice or assistance to an individual wishing to end his/her life provided certain conditions are met. This new legislation makes legal the provision for physician and/or nurse practitioner assistance in dying (through euthanasia or assisted suicide) for individuals in specified conditions. 
The current study is an unfunded survey of members of the CPA and/ or Provincial Psychological Associations in order to assess their attitudes toward, familiarity with, and thoughts and experiences regarding the new Canadian Medical Assistance in Dying (MAID) legislation.
One of the requirements for MAID is that an individual must be experiencing a “grievous” and "irremediable" health condition(s). Psychologists often work with individuals with “grievous and irremediable” health conditions, as well as with individuals who wish to hasten their own death. Moreover, psychologists assume a role in alleviating despair and distress, and in assessing psychological conditions and disorders. Consequently, the CPA is interested in learning about the opinions, attitudes and experiences of its members regarding the new MAID legislation, and assisted dying in general. As such, the survey will also examine the extent to which psychologists feel they possess the knowledge and training to work with individuals requesting MAID; and psychologists’ views on extending MAID provisions to individuals with mental disorders, dementia, and mature minors.
This study use an online survey form developed by a CPA Working Group to evaluate Canadian Psychologists’ thoughts and experiences regarding MAID. The results of this survey will be shared with the Executive Committee of the CPA and may help in guiding organizational policy and practice guidelines for the role of psychologists in end-of-life care. The results of the survey are intended to be disseminated in scholarly fora, such as conference presentations and publications.
This online study involves you providing some demographic information and responding to questions examining your opinions on MAID.  These questions include items from the new questionnaires that we are developing and from existing questionnaires assessing similar topic areas.  Participation in this study may take 20-30 minutes of your time. 
If you choose to participate in this study, you will be asked to click the “next” button appearing at the end of this form, which will take you to a screen on which you can indicate your consent to participate in this study.  All responses will be anonymous; the survey will be enabled with cookies to prevent the survey from being completed more than once by the same individual. 
If you decide to participate, your consent for this study will not expire unless you cancel (revoke) it.  You can always cancel this consent by simply closing your Internet browser or otherwise disconnecting from the study site.  If you cancel your consent, you will also be removed from the study.  If you decide to withdraw from this study, no additional information will be collected from you for study-related purposes, however information collected prior to your withdrawal from the study may be used for study analyses.  You can refuse to click the “next” button on the consent screen that follows and not be part of the study.  By clicking the “next” button on the consent screen, you give us permission to use and/or share your information as stated.
We hope to have a minimum of 300 people take part in this study.
The topic of MAID may evoke feelings of discomfort and unease in some people. We will only ask questions that we think are important for the purposes of the study. We do not expect that the questions will have any lasting negative effects on you. 
We cannot promise any benefits from participating in this study. However, some people find it interesting to take part in a study because they may be able to learn something about themselves. Your participation in this survey may help in the development of organizational policy and practice guidelines for psychologists’ roles in end-of-life mental healthcare.
Your confidentiality will be respected.  We will not collect any information regarding your personal identity. Results of the research may be presented at meetings or in publications.  We will keep the study information for at least 15 years after data collection is complete or at least 5 years after our last study publication, whichever is longer.  
We will make every effort to keep your study information private, however this cannot be guaranteed. Online data collection is being conducted using Lime Survey, an electronic data collection service that adheres to Canadian privacy legislation.  To protect study data, an automatic back-up takes place nightly at Nuvollo Corp (in Toronto), which houses the CPA’s servers.  Data is stored in a password-protected account, accessible only to the CPA’s Science Directorate.  Once the online data collection is complete, we will delete all information from this online account.  Although study data are being collected and stored by the CPA, they are anonymous; as such, your participation or non-participation in this study will have no impact on your current or future standing with the CPA.
Representatives of the Western University Health Sciences Research Ethics Board or of the Lawson Health Research Institute Quality Assurance and Education Program may require access to your study-related records to monitor the conduct of the study. By consenting to participate in this study, you additionally acknowledge being aware that your study information may exist in an online account, accessible to the CPA’s Science Directorate only until the end of data collection, after which point it will disappear permanently from the Nuvollo Corp. server. 
You may choose not to participate in this study. 
If you would like more information or if you have any concerns about this study, please call:
Dr. Marnin Heisel, Principal Investigator on behalf of the CPA MAID Working Group, at (519) 685-8500, ext. 75981.
If you have questions about your rights as a research participant or the conduct o f the study, you may contact the Offce of Human Research Ethics at Western University at (519) 661-3036. 
There will be no compensation for participating in this study nor any charge to you for participating. 
Participation in this study is voluntary. You may refuse to participate, refuse to answer any questions or withdraw from the study at any time, with no effect on your current or future relationship with the CPA.
You do not waive any legal rights by consenting to participate in this study.  You are welcome to print out a copy of this letter and your consent for your records. 
You may print a copy of this document by using your web browser print options or by simultaneously pressing the "Ctrl" and "P" buttons on your keyboard.  To make the document print-out more readable, switch the page format to "Landscape" using the "Page Setup" options under the "File" tab.
Please click "next" to advance to the consent screen. 


A note on privacy
This survey is anonymous.
The record of your survey responses does not contain any identifying information about you, unless a specific survey question explicitly asked for it. If you used an identifying token to access this survey, please rest assured that this token will not be stored together with your responses. It is managed in a separate database and will only be updated to indicate whether you did (or did not) complete this survey. There is no way of matching identification tokens with survey responses.

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