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How can we improve the experiences of patients and families who request medical assistance in dying? A multi-centre qualitative study Oczkowski, Simon J. W.; Crawshaw, Diane E.; Austin, Peggy; Versluis, Donald; Kalles-Chan, Gaelen; Kekewich, Michael; Curran, Dorothyann; Miller, Paul; Kelly, Michaela; Wiebe, Ellen; Frolic, Andrea

Abstract

Background Medical assistance in dying has been available in Canada for 5 years, but it is unclear which practices contribute to high-quality care. We aimed to describe patient and family perspectives of quality of care for medical assistance in dying. Methods We conducted a multi-centre, qualitative descriptive study, including face to face or virtual one-hour interviews using a semi-structured guide. We interviewed 21 english-speaking patients found eligible for medical assistance in dying and 17 family members at four sites in Canada, between November 2017 and September 2019. Interviews were de-identified, and analyzed in an iterative process of thematic analysis. Results We identified 18 themes. Sixteen themes were related to a single step in the process of medical assistance in dying (MAID requests, MAID assessments, preparation for dying, death and aftercare). Two themes (coordination and patient-centred care) were theme consistently across multiple steps in the MAID process. From these themes, alongside participant recommendations, we developed clinical practice suggestions which can guide care. Conclusions Patients and families identified process-specific successes and challenges during the process of medical assistance in dying. Most importantly, they identified the need for care coordination and a patient-centred approach as central to high-quality care. More research is required to characterize which aspects of care most influence patient and family satisfaction.

Item Metadata

Title
How can we improve the experiences of patients and families who request medical assistance in dying? A multi-centre qualitative study
Creator
Oczkowski, Simon J. W.; Crawshaw, Diane E.; Austin, Peggy; Versluis, Donald; Kalles-Chan, Gaelen; Kekewich, Michael; Curran, Dorothyann; Miller, Paul; Kelly, Michaela; Wiebe, Ellen; Frolic, Andrea
Publisher
BioMed Central
Date Issued
2021-12-08
Description
Background Medical assistance in dying has been available in Canada for 5 years, but it is unclear which practices contribute to high-quality care. We aimed to describe patient and family perspectives of quality of care for medical assistance in dying. Methods We conducted a multi-centre, qualitative descriptive study, including face to face or virtual one-hour interviews using a semi-structured guide. We interviewed 21 english-speaking patients found eligible for medical assistance in dying and 17 family members at four sites in Canada, between November 2017 and September 2019. Interviews were de-identified, and analyzed in an iterative process of thematic analysis. Results We identified 18 themes. Sixteen themes were related to a single step in the process of medical assistance in dying (MAID requests, MAID assessments, preparation for dying, death and aftercare). Two themes (coordination and patient-centred care) were theme consistently across multiple steps in the MAID process. From these themes, alongside participant recommendations, we developed clinical practice suggestions which can guide care. Conclusions Patients and families identified process-specific successes and challenges during the process of medical assistance in dying. Most importantly, they identified the need for care coordination and a patient-centred approach as central to high-quality care. More research is required to characterize which aspects of care most influence patient and family satisfaction.
Subject
Euthanasia; Suicide, assisted; Quality of care; Patient-focused research; Qualitative research
Genre
Article
Type
Text
Language
eng
Date Available
2022-01-19
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0406306
URI
http://hdl.handle.net/2429/80684
Affiliation
Medicine, Faculty of; Non UBC; Family Practice, Department of
Citation
BMC Palliative Care. 2021 Dec 08;20(1):185
Publisher DOI
10.1186/s12904-021-00882-4
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher; Other
Copyright Holder
The Author(s)
Rights URI
http://creativecommons.org/licenses/by/4.0/
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Rights

Attribution 4.0 International (CC BY 4.0)