Supporting Nurses in Medical Assistance in Dying (MAiD) Through Debriefing and Reflective Practice : A Scoping Review

Medical Assistance in Dying (MAiD) places nurses in ethically complex and emotionally demanding roles that may contribute to moral distress and emotional burden. While debriefing and reflective practices are widely used in healthcare to support clinicians following difficult clinical events, their application within MAiD contexts remains unclear. This scoping review mapped the existing literature on debriefing and reflective interventions supporting nurses involved in the MAiD process. Guided by the Arksey and O’Malley framework and Joanna Briggs Institute guidance, searches were conducted in MEDLINE, CINAHL, and PsycINFO. Eight studies were identified and included all of which were conducted in jurisdictions where assisted dying is legally practiced, including Australia, Canada, Belgium, New Zealand, and Spain. The studies primarily used qualitative approaches to examine nurses’ experiences of emotional labour, ethical complexity, and professional support within MAiD care. Findings demonstrated that formal debriefing practices are limited, variable in structure and facilitation, and often supplemented or replaced by informal peer-based reflection. Nurses identified the need for psychologically safe, accessible, and flexible debriefing opportunities, with preferences varying in timing, format, and participants involved. Importantly, the absence of structured reflective support may contribute to unresolved moral distress and the accumulation of moral residue, which may impact clinician well-being, participation in MAiD, and potentially access to care. Taken together, the findings indicate a need for approaches that are sensitive to context and attentive to ethical considerations, and supportive of both individual clinicians and sustainable MAiD practice.