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Characterizing Interdisciplinary U.S. Hospice Clinician Presence During Patient Self-Administration of Medical Aid in
Todd D Becker1, Denae J Gerasta2,3, Grant Yoder3,4
1Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.
Background:
Despite emerging as a clinical and scholarly focus in medical aid in dying (MAID)-related care, limited data exist to characterize hospice clinician presence while patients self-administer the medication to hasten their death.
Objectives:
To explore (1) the proportion and (2) correlates of interdisciplinary hospice clinician presence during patient self-administration of MAID medication.
Design:
Exploratory secondary analysis of cross-sectional survey data.
Setting/Subjects:
Convenience sample of interdisciplinary U.S. hospice clinicians reporting permissive state and organizational MAID policy.
Measurements:
We assessed the proportion of the sample ever having been present during patient self-administration of MAID medication via frequency and percentage. We examined personal, professional, organizational, and MAID-specific characteristics as correlates via multiple logistic regression analysis adjusted for small sample bias.
Results:
Our sample included 100 hospice physicians, nurses, social workers, and chaplains. Descriptive results revealed that just over one-third of the sample had ever been present during patient self-administration of MAID medication. Regression results indicated that being a chaplain and working for a hospice with a policy permitting full MAID participation were each significantly associated with greater odds of ever having been present. Conversely, never having provided end-of-life care beyond information provision related to a hospice patient's use of MAID was significantly associated with lower odds of ever having been present.
Conclusions:
Hospice clinician presence during patient self-administration of MAID medication appears relatively common and related to select professional, organizational, and MAID-specific characteristics. Improved annual state reporting practices and expanded replication efforts are warranted.
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