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Communication Processes and Priorities in Medical Aid in Dying Conversations: A Cross-Sectional Qualitative Study of
Meghan McDarby1, Alix Youngblood2, Megan Miller3
1Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Background:
Medical aid in dying (MAiD) is a practice that enables eligible individuals with a terminal, life-limiting illness to end their lives in a self-directed way. Multidisciplinary care teams play a vital role in facilitating discussions and patient decision making about MAiD in cancer care settings. However, little is known about how multidisciplinary care teams navigate MAiD discussions to provide effective, person-centered care.
Objectives:
To identify the communication priorities and processes that cancer care clinicians believe are most critical for multidisciplinary care teams when discussing MAiD with patients who have cancer.
Design:
Cross-sectional online survey.
Setting/Subjects:
Multidisciplinary clinicians who participated in a communication training program supported by the National Cancer Institute (N = 160) responded to five open-ended survey questions about communication considerations when working with a hypothetical patient with glioblastoma considering MAiD. Participants were presented with a case scenario and invited to describe how they would communicate with that patient as a member of a multidisciplinary team. A thematic analysis of responses using an iterative, inductive approach was conducted until saturation was reached.
Results:
Four themes were identified as communication priorities and processes critical for multidisciplinary teams when discussing MAiD with cancer patients: (1) addressing complexity of MAiD in GBM; (2) thorough palliative care assessment; (3) strategies for clinicians and healthcare systems to optimize MAiD discussions; and (4) person-centered care that de-stigmatizes MAiD.
Conclusions:
Findings underscore the distinct complexity of MAiD discussions in oncology and highlight the need for tailored, person-centered approaches that go beyond standard end-of-life communication.
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