The Quality of Bereavement for Caregivers of Patients Who Died by Medical Assistance in Dying at Home and the Factors Impacting Their Experience: A Qualitative Study

2021 ◽  
Author(s):  
Narges Hashemi ◽  
Elizabeth Amos ◽  
Bhadra Lokuge
Keyword(s):  
Qualitative Study ◽  
Medical Assistance ◽  
Medical Assistance In Dying ◽  
Dying At Home ◽  
At Home

scholarly journals Organ donation after medical assistance in dying at home

2018 ◽  
Vol 190 (44) ◽  
pp. E1305-E1306
Author(s):  
Johannes Mulder ◽  
Johan P.C. Sonneveld
Keyword(s):  
Organ Donation ◽  
Medical Assistance ◽  
Medical Assistance In Dying ◽  
Dying At Home ◽  
At Home

Lung donation after medical assistance in dying at home

2020 ◽  
Vol 21 (1) ◽  
pp. 415-418
Author(s):  
Andrew Healey ◽  
Marcelo Cypel ◽  
Helen Pyle ◽  
Caitlin Mills ◽  
Jodie Heffren ◽  
...  
Keyword(s):  
Medical Assistance ◽  
Medical Assistance In Dying ◽  
Dying At Home ◽  
At Home

Improving the Medical Assistance in Dying (MAID) process: A qualitative study of family caregiver perspectives

2019 ◽  
Vol 17 (5) ◽  
pp. 590-595 ◽  
Author(s):  
Brigette M. Hales ◽  
Sally Bean ◽  
Elie Isenberg-Grzeda ◽  
Bill Ford ◽  
Debbie Selby
Keyword(s):  
Family Caregivers ◽  
Family Caregiver ◽  
Medical Assistance ◽  
Institutional Level ◽  
The Road ◽  
Medical Assistance In Dying ◽  
Practice Standards ◽  
Qualitative Descriptive ◽  
Family Privacy

AbstractObjectiveThe road to legalization of Medical Assistance in Dying (MAID) across Canada has largely focused on legislative details such as eligibility and establishment of regulatory clinical practice standards. Details on how to implement high-quality, person-centered MAID programs at the institutional level are lacking. This study seeks to understand what improvement opportunities exist in the delivery of the MAID process from the family caregiver perspective.MethodThis multi-methods study design used structured surveys, focus groups, and unstructured e-mail/phone conversations to gather experiential feedback from family caregivers of patients who underwent MAID between July 2016 and June 2017 at a large academic hospital in Toronto, Canada. Data were combined and a qualitative, descriptive approach used to derive themes within family perspectives.ResultImprovement themes identified through the narrative data (48% response rate) were grouped in two categories: operational and experiential aspects of MAID. Operational themes included: process clarity, scheduling challenges and the 10-day period of reflection. Experiential themes included clinician objection/judgment, patient and family privacy, and bereavement resources.Significance of resultsTo our knowledge, this is the first time that family caregivers’ perspectives on the quality of the MAID process have been explored. Although practice standards have been made available to ensure all legislated components of the MAID process are completed, detailed guidance for how to best implement patient and family centered MAID programs at the institutional level remain limited. This study provides guidance for ways in which we can enhance the quality of MAID from the perspective of family caregivers.

scholarly journals Riding an elephant: A qualitative study of nurses' moral journeys in the context of Medical Assistance in Dying (MAiD)

2020 ◽  
Author(s):  
Barbara Pesut ◽  
Sally Thorne ◽  
Janet Storch ◽  
Kenneth Chambaere ◽  
Madeleine Greig ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Medical Assistance ◽  
Medical Assistance In Dying

Influences on place of death in Botswana

2010 ◽  
Vol 8 (2) ◽  
pp. 177-185 ◽  
Author(s):  
Mark Lazenby ◽  
Tony Ma ◽  
Howard J. Moffat ◽  
Marjorie Funk ◽  
M. Tish Knobf ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Causes Of Death ◽  
Death Certificate ◽  
Female Gender ◽  
Place Of Death ◽  
Hospital Deaths ◽  
The Mean ◽  
Dying At Home ◽  
At Home

AbstractObjective:There is an emerging body of research aimed at understanding the determinants of place of death, as where people die may influence the quality of their death. However, little is known about place of death for people of Southern Africa. This study describes place of death (home or hospital) and potential influencing factors (cause of death, age, gender, occupation, and district of residence).Method:We collected the death records for years 2005 and 2006 for all adult non-traumatic deaths that occurred in Botswana, described them, and looked for associations using bivariate and multivariate analyses.Results:The evaluable sample consisted of 18,869 death records. Home deaths accounted for 36% of all deaths, and were predominantly listed with “unknown” cause (82.3%). Causes of death for hospital deaths were HIV/AIDS (49.7%), cardiovascular disease (13.8%), and cancer (6.6%). The mean age at the time of all deaths was 53.2 years (SD = 20.9); with 61 years (SD = 22.5) for home deaths and 48.8 years (SD = 18.6) for hospital deaths (p < .001). Logistic regression analysis revealed the following independent predictors of dying at home: unknown cause of death; female gender; >80 years of age; and residing in a city or rural area (p < .05).Significance of Results:A major limitation of this study was documentation of cause of death; the majority of people who died at home were listed with an unknown cause of death. This finding impeded the ability of the study to determine whether cause of death influenced dying at home. Future study is needed to determine whether verbal autopsies would increase death-certificate listings of causes of home deaths. These data would help direct end-of-life care for patients in the home.

scholarly journals Exploring Canadian Physicians' Experiences Providing Medical Assistance in Dying: A Qualitative Study

2018 ◽  
Vol 56 (2) ◽  
pp. 222-229.e1 ◽  
Author(s):  
Narges Khoshnood ◽  
Marie-Clare Hopwood ◽  
Bhadra Lokuge ◽  
Allison Kurahashi ◽  
Anastasia Tobin ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Medical Assistance ◽  
Medical Assistance In Dying

scholarly journals Irremediable psychiatric suffering in the context of medical assistance in dying: a qualitative study

2021 ◽  
Author(s):  
Sisco M.P. van Veen ◽  
Andrea Ruissen ◽  
Aartjan Beekman ◽  
Natalie Evans ◽  
Guy Widdershoven
Keyword(s):  
Qualitative Study ◽  
Psychiatric Disorder ◽  
Diagnosis And Treatment ◽  
Medical Assistance ◽  
Clinical Criteria ◽  
Medical Assistance In Dying ◽  
Main Challenge ◽  
Prospective Assessment ◽  
History Of ◽  
Patient’S Perception

Background: Establishing irremediability is a central challenge in determining the appropriateness of medical assistance in dying (MAID) for patients with a psychiatric disorder. The objective of this study is to learn how experienced psychiatrists define irremediable psychiatric suffering (IPS) in the context of MAID and what challenges they face while establishing IPS. Methods: In a qualitative study, we performed 11 in-depth interviews with psychiatrists who have experience assessing IPS in the context of MAID. Results: Although determining IPS is, essentially, a prospective assessment, psychiatrists mostly rely on retrospective dimensions, such as the history of failed treatments, when defining IPS. When establishing IPS, psychiatrists face diagnosis and treatment challenges. The main challenge regarding diagnosis is that patients requesting MAID are often diagnosed with more than one psychiatric disorder. Important treatment related challenges are: assessing the quality of past treatments, establishing the limits of approaches that aim to alter the patient's perception, and managing 'treatment fatigue' and treatment refusal. Interpretation: IPS is mostly defined in terms of failed past treatments. Challenges regarding diagnosis and treatment complicate the process of establishing IPS. The finding that most patients are diagnosed with more than one psychiatric disorder calls for a critical appraisal of the due diligence procedure for MAID. In response to the challenges related to treatment, intersubjective clinical criteria for IPS in the context of MAID should be developed. Also, further investigation of the concept of 'treatment fatigue' in psychiatry may provide insight into why patients requesting MAID. Registration: this study was preregistered under osf.io/2jrnd.

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