Department of Sociology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Department of Health Policy and Management, University of California Los Angeles, Los Angeles, California, USA.
Sociol Health Illn. 2019 Jul;41(6):1175-1191. doi: 10.1111/1467-9566.12903. Epub 2019 Apr 4.
The range of end-of-life options is expanding across North America. Specifically, medical aid in dying (AID), or the process by which a patient with a terminal illness may request medical assistance with hastening death, has recently become legal in eight jurisdictions in the United States and all of Canada. Debates about AID often rely on cultural constructions that define some deaths as 'good' and others as 'bad'. While research has found commonalities in how patients, family members and health care providers define good and bad deaths, these constructions likely vary across social groups. Because of this, the extent to which AID is seen as a route to the good death also likely varies across social groups. In this article, we analyse qualitative data from six focus groups (n = 39) across three racial and ethnic groups: African American, Latino and white Californians, just after a medical AID law was passed. We find that definitions of the 'good death' are nuanced within and between groups, suggesting that different groups evaluate medical AID in part through complex ideas about dying. These findings further conversations about racial and ethnic differences in choices about end-of-life options.
北美地区的临终选择范围正在扩大。具体来说，医疗辅助自杀（AID），即绝症患者可以请求医疗协助加速死亡的过程，最近在美国的八个司法管辖区和加拿大全境都合法化了。关于 AID 的辩论通常依赖于文化构建，这些构建将某些死亡定义为“好”，而将其他死亡定义为“坏”。尽管研究发现了患者、家属和医疗保健提供者如何定义好死和坏死的共同点，但这些构建在不同的社会群体中可能有所不同。因此，AID 被视为通往美好死亡的途径的程度也可能因社会群体而异。在本文中，我们分析了在加利福尼亚州的三个种族和族裔群体（非裔美国人、拉丁裔和白人）中的六个焦点小组（n=39）的定性数据，这些群体在一项医疗 AID 法律通过后不久接受了调查。我们发现，“美好死亡”的定义在群体内部和群体之间是复杂的，这表明不同群体通过关于死亡的复杂观念在一定程度上评估了医疗 AID。这些发现进一步探讨了在临终选择方面存在的种族和族裔差异。
