The impact of COVID-19 on the experiences of patients and their family caregivers with medical assistance in dying in hospital

BMC Palliative Care

Research

Elie Isenberg-Grzeda¹  Eryn Tong²  Sarah Hales³  Madeline Li³  Gary Rodin³  Rinat Nissim³  Tharshika Thangarasa³  Debbie Selby⁴  Sally Bean⁴ 

[1] Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada;Sunnybrook Health Sciences Centre, Toronto, ON, Canada;Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, Toronto, ON, Canada;Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, Toronto, ON, Canada;Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada;Sunnybrook Health Sciences Centre, Toronto, ON, Canada;

关键词: Medical assistance in dying;    Qualitative research;    Assisted dying;    COVID-19 pandemic;    Canada;   

DOI  :  10.1186/s12904-023-01191-8

 received in 2022-08-03, accepted in 2023-06-03,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe COVID-19 pandemic and its containment measures have drastically impacted end-of-life and grief experiences globally, including those related to medical assistance in dying (MAiD). No known qualitative studies to date have examined the MAiD experience during the pandemic. This qualitative study aimed to understand how the pandemic impacted the MAiD experience in hospital of persons requesting MAiD (patients) and their loved ones (caregivers) in Canada.MethodsSemi-structured interviews were conducted with patients who requested MAiD and their caregivers between April 2020 and May 2021. Participants were recruited during the first year of the pandemic from the University Health Network and Sunnybrook Health Sciences Centre in Toronto, Canada. Patients and caregivers were interviewed about their experience following the MAiD request. Six months following patient death, bereaved caregivers were interviewed to explore their bereavement experience. Interviews were audio-recorded, transcribed verbatim, and de-identified. Transcripts were analyzed using reflexive thematic analysis.ResultsInterviews were conducted with 7 patients (mean [SD] age, 73 [12] years; 5 [63%] women) and 23 caregivers (mean [SD] age, 59 [11] years; 14 [61%] women). Fourteen caregivers were interviewed at the time of MAiD request and 13 bereaved caregivers were interviewed post-MAiD. Four themes were generated with respect to the impact of COVID-19 and its containment measures on the MAiD experience in hospital: (1) accelerating the MAiD decision; (2) compromising family understanding and coping; (3) disrupting MAiD delivery; and (4) appreciating rule flexibility.ConclusionsFindings highlight the tension between respecting pandemic restrictions and prioritizing control over the dying circumstances central to MAiD, and the resulting impact on patient and family suffering. There is a need for healthcare institutions to recognize the relational dimensions of the MAiD experience, particularly in the isolating context of the pandemic. Findings may inform strategies to better support those requesting MAiD and their families during the pandemic and beyond.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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