"Walk me through the final day": A thematic analysis study on the family caregiver experience of the Medical Assistance in Dying procedure day.

BACKGROUND

Legalization of assisted dying is progressively expanding worldwide. In Canada, the Medical Assistance in Dying Act became law in 2016. As assisted dying regulations evolve worldwide, comprehending its subjective impact and broader consequences, especially on family members, becomes pivotal for shaping practice, policy, and training.

AIM

The goal of this study is to understand the experience of family caregivers on the assisted dying procedure day.

DESIGN

Qualitative, thematic analysis, research using semi-structured interviews.

SETTING/PARTICIPANTS

Family caregivers of patients who received assisted dying in two hospitals in Canada were recruited. Interviews were conducted at least 6 months after patient death. Conceptual saturation was achieved after analyzing 18 interviews.

RESULTS

While caregivers expressed gratitude for the availability of Medical Assistance in Dying, they also described the procedure day as potentially jarring and unsettling. We identified five aspects that shaped their experience: attuned support from the clinical team; preparation for clinical details; congruence between the setting and the importance of the event; active participation and ceremony; and pacing and timing of the procedure. Together, these aspects impacted the level of uneasiness felt by caregivers on the procedure day.

CONCLUSIONS

This study emphasized the importance of a family-centered approach to delivering Medical Assistance in Dying. It underscored recognizing the needs of family caregivers during the procedure day and offering strategies to ease their experience. Healthcare providers in jurisdictions where assisted dying is legal or deliberated should consider the applicability of these findings to their unique context.

Déclaration de conflit d'intérêts

Declaration of conflicting interestsThe author(s) declare they have no potential conflicts of interest with respect to the research, authorship, and/or publication of this article other than authors’ roles in the medical assistance in dying programs at the University Health Network (SH, GR, ML) and Sunnybrook Health Sciences Centre (DS, SB, EIG).