The following is a summary of “Care considerations in medical assistance in dying for persons with mental illness as the sole underlying medical condition: a qualitative study of patient and family perspectives,” published in the February 2024 issue of Psychiatry by Stergiopoulos et al.
Limited research has explored the perspectives of patients and their families regarding the care processes for Medical Assistance in Dying (MAiD) in cases where mental illness is the sole underlying medical condition (MI-SUMC), a practice anticipated to be eligible in Canada from March 17th, 2024, and currently allowed in select countries like Belgium, the Netherlands, Luxembourg, and Switzerland.
Researchers conducted a retrospective study to explore the viewpoints of individuals with personal experiences of mental illness and their family members regarding care considerations in the implementation of MI-SUMC.
They conducted interviews with 30 adults who had personal experience with mental illness and 25 adult family members from Ontario. To enhance participant involvement, a semi-structured interview format employed persona-scenario exercises to explore perspectives on the acceptability of MI-SUMC and care considerations related to MAiD. Data analysis utilized framework analysis with NVivo 12 Pro, involving the inductive examination of narratives. Following data familiarization, steps, processes, and care considerations suggested by participants were organized into a framework matrix. Key themes were subsequently identified, with input from a lived-experience advisory group involved in all study aspects.
The results showed that six themes emerged from the narratives of patients and family members, including, Increasing awareness of MAiD MI-SUMC, Introducing MAiD MI-SUMC sensitively during discussions about care goals, responding to requests for MAiD MI-SUMC with a focus on the individual, providing comprehensive care within the framework of MAiD MI-SUMC, conducting a holistic, person-centered assessment process; and providing support following the decision-making process. These themes indicated a shared perspective between patients and their families, emphasizing the importance of person-centered care, non-judgmental attitudes from healthcare providers, holistic interdisciplinary care, collaborative decision-making, and respecting patient autonomy in healthcare decisions.
Investigators concluded that involving families and patients in MAiD MI-SUMC implementation is crucial for crafting effective services and addressing diverse community needs.
Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05541-5