Care Considerations in a Patient- and Family-Centered Medical Assistance in Dying Program

Area of Science:

• Medical Ethics
• Palliative Care
• Qualitative Research

Background:

• Medical Assistance in Dying (MAID) legalized in Canada in 2016.
• Project aimed to enhance patient- and family-centered care (PFCC) in MAID programs.
• Qualitative data from patients, families, and providers were collected.

Purpose of the Study:

• Assess opportunities to enhance PFCC in MAID.
• Identify patient, family, and provider experiences with MAID.
• Inform improvements in end-of-life care for MAID recipients.

Main Methods:

• Conducted 30 qualitative interviews (5 patients, 11 family, 14 providers).
• Interviews focused on experiences with MAID.
• Utilized comparative coding and thematic analysis with NVivo12.

Main Results:

• Identified key PFCC considerations: emotional, physical, spiritual, and relational.
• Emotional: validating journey, navigating uncertainty, impact on families/teams.
• Physical: sensitive assessments, interdisciplinary care, anticipatory guidance, death location.
• Spiritual: honoring choice, life stories, spiritual needs, loss.
• Relational: defining/supporting circles of care, relational investments.

Conclusions:

• Holistic care requires dedicated time for practitioners.
• Programmatic suggestions: early interdisciplinary care, consistent providers, guidance, bereavement support, dedicated MAID space.
• Involve patients and families in MAID program development for quality end-of-life care.