How can we improve the experiences of patients and families who request medical assistance in dying? A multi-centre qualitative study
Open accessAbstract
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.
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Prior literature on patient and family perspectives on MAiD delivery highlights care coordination and patient-centered approaches as central to high-quality care.
“The scant available literature on patient and family perspectives on MAiD delivery to date highlights care coordination and patient-centered approaches as central to high-quality care [24].”
These perspectives support and are supported by prior research calling for MAiD care coordination, inter-professional approaches, and attention to applicants' and families' emotional, social and spiritual needs.
“These perspectives support and are supported by prior research calling for MAiD care coordination, inter-professional approaches, and attention to applicants’ and families’ emotional, social and spiritual needs, among others [24, 25, 50–52].”
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Stergiopoulos, V., Bastidas-Bilbao, H., Gupta, M., Buchman, D. Z., Stewart, D. E., Rajji, T., Simpson, A. I. F., van Kesteren, M. R., Cappe, V., Castle, D., et al. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05541-5 · Cited by 5 · see citing works
- Authors
- Oczkowski, S. J. W., Crawshaw, D. E., Austin, P., Versluis, D., Kalles-Chan, G., Kekewich, M., Curran, D., Miller, P., Kelly, M., Wiebe, E., & Frolic, A.
- Affiliations
- Juravinski Hospital (CA)
- Island Health (CA)
- Hamilton Health Sciences (CA)
- Ottawa Hospital (CA)
- London School of Hygiene & Tropical Medicine (GB)
- University of British Columbia (CA)
- Corresponding author
- Oczkowski, Simon J. W.
- Venue
- BMC Palliative Care
- Published
- 2021-12
- Volume
- 20
- Issue
- 1
- Pages
- 185-185
- ISSN
- 1472-684X (ISSN-L)
- PMC
- PMC8653618
- OpenAlex
- W4200610522
- Cited by
- 47
- References
- 22
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 19 · 2023: 12 · 2022: 3
- FWCI
- 7.35
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Palliative Care (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- uO Research (University of Ottawa) (submittedVersion, public-domain)
- cIRcle (University of British Columbia) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- McMaster University
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- medical assistance in dying, patient experience, family perspectives, quality of care, care coordination, patient-centered care, follow-up care, end-of-life care, patient satisfaction
- MeSH terms
- Canada, Humans, Medical Assistance, Quality of Health Care, Suicide, Assisted, Qualitative Research
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