The impact of COVID-19 on the experiences of patients and their family caregivers with medical assistance in dying in hospital
Abstract Background The 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...
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Palliative Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12904-023-01191-8 |
| _version_ | 1797801182224187392 |
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| author | Eryn Tong Rinat Nissim Debbie Selby Sally Bean Elie Isenberg-Grzeda Tharshika Thangarasa Gary Rodin Madeline Li Sarah Hales |
| author_facet | Eryn Tong Rinat Nissim Debbie Selby Sally Bean Elie Isenberg-Grzeda Tharshika Thangarasa Gary Rodin Madeline Li Sarah Hales |
| author_sort | Eryn Tong |
| collection | DOAJ |
| description | Abstract Background The 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. Methods Semi-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. Results Interviews 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. Conclusions Findings 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. |
| first_indexed | 2024-03-13T04:46:33Z |
| format | Article |
| id | doaj.art-7ddb4b0f509d4bf09d94df712d28d099 |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-03-13T04:46:33Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-7ddb4b0f509d4bf09d94df712d28d0992023-06-18T11:28:08ZengBMCBMC Palliative Care1472-684X2023-06-012211810.1186/s12904-023-01191-8The impact of COVID-19 on the experiences of patients and their family caregivers with medical assistance in dying in hospitalEryn Tong0Rinat Nissim1Debbie Selby2Sally Bean3Elie Isenberg-Grzeda4Tharshika Thangarasa5Gary Rodin6Madeline Li7Sarah Hales8Department of Supportive Care, Princess Margaret Cancer Centre, University Health NetworkDepartment of Supportive Care, Princess Margaret Cancer Centre, University Health NetworkSunnybrook Health Sciences CentreSunnybrook Health Sciences CentreDepartment of Psychiatry, Faculty of Medicine, University of TorontoDepartment of Supportive Care, Princess Margaret Cancer Centre, University Health NetworkDepartment of Supportive Care, Princess Margaret Cancer Centre, University Health NetworkDepartment of Supportive Care, Princess Margaret Cancer Centre, University Health NetworkDepartment of Supportive Care, Princess Margaret Cancer Centre, University Health NetworkAbstract Background The 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. Methods Semi-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. Results Interviews 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. Conclusions Findings 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.https://doi.org/10.1186/s12904-023-01191-8Medical assistance in dyingQualitative researchAssisted dyingCOVID-19 pandemicCanada |
| spellingShingle | Eryn Tong Rinat Nissim Debbie Selby Sally Bean Elie Isenberg-Grzeda Tharshika Thangarasa Gary Rodin Madeline Li Sarah Hales The impact of COVID-19 on the experiences of patients and their family caregivers with medical assistance in dying in hospital BMC Palliative Care Medical assistance in dying Qualitative research Assisted dying COVID-19 pandemic Canada |
| title | The impact of COVID-19 on the experiences of patients and their family caregivers with medical assistance in dying in hospital |
| title_full | The impact of COVID-19 on the experiences of patients and their family caregivers with medical assistance in dying in hospital |
| title_fullStr | The impact of COVID-19 on the experiences of patients and their family caregivers with medical assistance in dying in hospital |
| title_full_unstemmed | The impact of COVID-19 on the experiences of patients and their family caregivers with medical assistance in dying in hospital |
| title_short | The impact of COVID-19 on the experiences of patients and their family caregivers with medical assistance in dying in hospital |
| title_sort | impact of covid 19 on the experiences of patients and their family caregivers with medical assistance in dying in hospital |
| topic | Medical assistance in dying Qualitative research Assisted dying COVID-19 pandemic Canada |
| url | https://doi.org/10.1186/s12904-023-01191-8 |
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