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Background Compassionate communities are rooted in a health promotion approach to palliative care, aiming to support solidarity among community members at the end of life. Hundreds of compassionate communities have been developed internationally in recent years. However, it remains unknown how their implementation on the ground aligns with core strategies of health promotion. The aim of this review is to describe the practical implementation and evaluation of compassionate communities. Methods We undertook a scoping review of the empirical peer-reviewed literature on compassionate communities. Bibliographic searches in five databases were developed with information specialists. We included studies in English describing health promotion activities applied to end-of-life and palliative care. Qualitative analysis used inductive and deductive strategies based on existing frameworks for categorization of health promotion activities, barriers and facilitators for implementation and evaluation measures. A participatory research approach with community partners was used to design the review and interpret its findings. Results Sixty-three articles were included for analysis. 74.6% were published after 2011. Health services organizations and providers are most often engaged as compassionate community leaders, with community members mainly engaged as target users. Adaptation to local culture and social context is the most frequently reported barrier for implementation, with support and external factors mostly reported as facilitators. Early stages of compassionate community development are rarely reported in the literature (stakeholder mobilization, needs assessment, priority-setting). Health promotion strategies tend to focus on the development of personal skills, mainly through the use of education and awareness programs. Few activities focused on strengthening community action and building healthy public policies. Evaluation was reported in 30% of articles, 88% of evaluation being analyzed at the individual level, as opposed to community processes and outcomes. Conclusions The empirical literature on compassionate communities demonstrates a wide variety of health promotion practices. Much international experience has been developed in education and awareness programs on death and dying. Health promotion strategies based on community strengthening and policies need to be consolidated. Future research should pay attention to community-led initiatives and evaluations that may not be currently reported in the peer-review literature.

Background The practice of continuous palliative sedation until death is the subject of much medical and ethical debate, which is reflected in the inconsistency that persists in the literature regarding the definition and indications of palliative sedation. Aim This study aims to gain a better understanding of palliative care clinicians’ experiences with continuous palliative sedation. Design We conducted a qualitative study based on focus group discussions. Setting/participants We conducted six focus groups with a total of 28 palliative care clinicians (i.e., 15 nurses, 12 physicians, and 1 end-of-life doula) from diverse care settings across Canada, where assisted dying has recently been legalized. Results An interpretative phenomenological analysis was used to consolidate the data into six key themes: responding to suffering; grappling with uncertainty; adapting care to ensure ongoing quality; grounding clinical practice in ethics; combining medical expertise, relational tact, and reflexivity; and offering an alternative to assisted death. Conclusions Interaction with the patient’s family, uncertainty about the patient’s prognosis, the concurrent practice of assisted dying, and the treatment of existential suffering influence the quality of sedation and indicate a lack of clear palliative care guidelines. Nevertheless, clinicians exhibit a reflective and adaptive capacity that can facilitate good practice.

Marcoux discusses her review to identify factors influencing the use and evolution of Medical Assistance in Dying (MAiD) in jurisdictions where it has been legal for at least five years. The review examines socio-political, legal, organizational, cultural, and individual factors associated with MAiD requests and administrations. By analyzing evidence from multiple databases and grey literature, the study aims to clarify how these factors affect MAiD's prevalence and development over time. Understanding these influences can help healthcare practitioners and policymakers better navigate complex end-of-life care decisions and improve service delivery in different settings.

As of June 2025, medical assistance in dying (MAiD) is allowed in over 25 jurisdictions across 12 countries, with varying rates of requests and provision. Hypotheses have been suggested to explain these variations, but they are rarely backed up by empirical evidence. As more jurisdictions consider legalizing MAiD, it is important to better understand what factors may explain the evolution of the use of MAiD worldwide with a systematic approach. This scoping review aims to map the available evidence regarding the factors associated with the evolution of the use of MAiD in jurisdictions where it is allowed. The scoping review will follow the Joanna Briggs Institute methodology and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Ten electronic databases (including MEDLINE, Embase, CINAHL Complete, and APA PsycInfo) and additional gray literature sources will be searched from inception to the present. This scoping review will consider multiple types of publications (eg, primary studies, research syntheses, and government reports) and will report factors associated with the use of MAiD for people who have requested or died by MAiD in jurisdictions that have allowed it for at least 5 years. Publications in English, French, Spanish, German, or Dutch will be included. Screening for assessment against the inclusion criteria and data extraction will be carried out independently by pairs of reviewers. Findings will be presented in a narrative format and mapped into tables and graphs to address the review aims. The database search for scientific publications was completed in March 2025. A total of 8570 publications were identified after removing duplicates. As of October 2025, title and abstract screening is complete, with 216 articles retained for the next stage. The full-text review is underway and scheduled to be completed by December 2025, and results are expected to be submitted for publication in 2026. MAiD is gaining legal and policy attention worldwide, with wide variation in rates of request and provision over time across jurisdictions. This scoping review will contribute to mapping and synthesizing evidence on the factors that may explain these variations.

Background: Compassionate communities are part of an international public health movement aiming to address social determinants of death by fostering supportive environments. Yet, empirical research on community engagement in this field is still limited, particularly the influence of local contexts on engagement patterns. Objectives: This study aimed to identify effective engagement practices and contextual factors influencing the development and sustainability of compassionate communities. Research design and method: A comparative ethnographic method was used to examine community engagement processes in two culturally distinct compassionate communities in Montréal (Canada): Centre-Sud and West Island. Data collection included participant observation, semistructured interviews, and logbooks. Informed by developmental evaluation, the analysis was guided by a thematic lens approach and the Ecology of Engagement framework. Results: Two distinct, context-sensitive paths to community engagement emerged, shaped by the sociocultural realities of each setting. In Centre-Sud, a grassroots, community-led approach focused on shared leadership and building trust fostered a resilient network that achieved sustainability through the creation of an independent nonprofit organization. In contrast, West Island’s institutionally led strategy was a pragmatic response to navigate contextual barriers like preexisting community distrust, achieving sustainability by embedding the initiative within the lead organization via a permanent staff role. Conclusion: This comparative ethnography demonstrates that success is not defined by a single model but by adapting engagement strategies to local dynamics of trust and power. It highlights that while community-led approaches can foster deep ownership, institutionally led strategies can provide a crucial pathway to sustainability in contexts facing systemic barriers. The study offers a practical framework for practitioners and key lessons for developing evidence-based policy to support compassionate communities in diverse settings. Plain language summary Developing compassionate communities: Lessons from two different Montréal neighborhoods Developing ‘compassionate communities’—local networks that support people through serious illness, grief, and the end of life—is a shared effort. This research explored the most effective ways to engage communities in this work by comparing two distinct Montréal neighborhoods: the downtown Centre-Sud area and the suburban West Island. We found that there’s no single recipe for success. In the downtown Centre-Sud area, community groups took the lead, building a strong, trusted network that eventually became its own non-profit organization to ensure sustainability. In the suburban West Island, a local palliative care residence guided the process, creating a permanent staff role to secure a lasting impact. The key lesson is that the best approach depends on a community’s unique character and history. Success comes from adapting the strategy to fit the local reality.

Breaking the silence: How safe spaces help communities connect through death and loss This study explored the social and cultural transformations within “compassionate communities,” local initiatives supporting those experiencing serious illness, death, and grief. We aimed to understand how these projects change the way people relate to mortality. For three years, our research team followed two distinct Montréal projects: a grassroots, community-led effort and an institutionally-led initiative. We analyzed their impact through 84 hours of participant observation and 26 interviews with 22 participants. We found that local settings acted as active forces, shaping how each community addressed its unique needs. For instance, programs tackled challenges such as the stigma of drug overdoses or “social death”—the profound separation from community life caused by the shame and isolation felt by victims of senior fraud. Despite their different paths, both projects successfully created “safe spaces” to bridge the gap between private loss and grief and a society that often lacks the rituals or social “scripts” needed to discuss loss. In these spaces, a powerful process we call “death sociability” emerged. Participants formed reciprocal relationships to learn from one another’s experiences, building lasting community resources like new skills for discussing loss and shared rituals to honor the dead. By addressing both the physical and social aspects of mortality, these initiatives foster the human connection needed for a more equitable and human-centered approach to death, dying, and grief.

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. 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. 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. 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. 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. DERR1-10.2196/83549.

Background: Compassionate communities build on health promoting palliative care that aims to address gaps in access, quality, and continuity of care in the context of dying, death, loss, and grief. While community engagement is a core principle of public health palliative care, it has received little attention in empirical studies of compassionate communities. Objectives: The objectives of this research are to describe the process of community engagement initiated by two compassionate communities projects, to understand the influence of contextual factors on community engagement over time, and assess the contribution of community engagement on proximal outcomes and the potential for sustaining compassionate communities. Research Approach and Design: We use a community-based participatory action-research approach to study two compassionate communities initiatives in Montreal (Canada). We develop a longitudinal comparative ethnographic design to study how community engagement evolves in different compassionate communities contexts. Methods and Analysis: Data collection includes focus groups, review of key documents and project logbooks, participant observation, semi-structured interviews with key informants, and questionnaires with a focus on community engagement. Grounded in the ecology of engagement theory and the Canadian compassionate communities evaluation framework, data analysis is structured around longitudinal and comparative axes to assess the evolution of community engagement over time and to explore the contextual factors influencing the process of community engagement and its impacts according to local context. Ethic: This research is approved by the research ethics board of the Centre hospitalier de l’Université de Montréal (approval certificate #18.353). Discussion: Understanding the process of community engagement in two compassionate communities will contribute to a deeper understanding of the relationships between local context, community engagement processes, and their effect on compassionate communities outcomes.

Few studies have examined whether training can improve competency in intervening with suicidal youths. In this study we attempted to verify the effectiveness of such a training program on helper competency. Forty‐three helpers who received the training were compared with 28 helpers who did not. Participants who received the training improved in knowledge, attitudes, and intervention skills following the training, compared with the control group across measures. Their gains were maintained at 6‐month follow‐up. In this sample, implementation of a one‐time training program improved helpers' competencies in youth suicide intervention.

L’objectif de cette synthèse des connaissances est de donner un aperçu des études scientifiques publiées sur les attitudes des intervenants en santé mentale envers l’euthanasie et le suicide assisté. Une recherche a été menée dans les bases de données Medline, PsycInfo et Embase ; onze articles répondant aux critères d’inclusion ont été sélectionnés. Les résultats montrent que les intervenants en santé mentale ont généralement des attitudes positives envers l’euthanasie et le suicide assisté, avec des attitudes un peu plus favorables envers ce dernier que pour l’euthanasie. Plusieurs études ont montré une corrélation négative entre l’importance de la religion et leurs attitudes ainsi qu’avec l’expérience professionnelle. Le lien entre les attitudes et d’autres caractéristiques personnelles (par ex. : le genre, l’âge, le niveau d’éducation) n’est toutefois pas constant d’une étude à l’autre. Des enjeux particuliers sur le plan de la méthodologie doivent être considérés dans l’interprétation des résultats, dont des différences dans les définitions et la terminologie utilisée, ainsi que dans la formulation des questions. Le lien entre les expériences personnelles et les attitudes envers l’euthanasie ou le suicide assisté devrait faire l’objet de recherches futures.