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双重边缘的医疗协助死亡家庭遗产:一项质性描述性研究

Double-edged MAiD death family legacy: a qualitative descriptive study.

作者信息

Frolic Andrea N, Swinton Marilyn, Murray Leslie, Oliphant Allyson

机构信息

Program for Ethics and Care Ecologies (PEaCE) and MAiD, Hamilton Health Sciences, Hamilton, Ontario, Canada

Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada.

出版信息

BMJ Support Palliat Care. 2020 Dec 18. doi: 10.1136/bmjspcare-2020-002648.

Abstract

BACKGROUND

Individuals who accompany a loved one through medical assistance in dying (MAiD) have to live with the experience and the psychological, moral and social consequences of their involvement in the process long after the death occurs.

AIM

To explore the legacy of a MAiD death for individuals who accompanied a loved one through the process.

DESIGN

Using a qualitative descriptive approach we conducted semi-structured interviews to collect data from family members who had accompanied a loved one through MAiD. Data were analysed using conventional content analysis.

SETTING/PARTICIPANTS: 16 family members of 14 patients who received MAiD at a Canadian hospital with an interdisciplinary MAiD programme.

RESULTS

The main theme in the analysis is the opposing tensions experienced by individuals who accompany a loved one through a MAiD death, which we conceptualise as a double-edge experience. This double-edge experience is illustrated through four thematic opposing tensions: (1) support for patient autonomy and ambivalence about the MAiD choice, (2) gratitude for suffering relieved for loved one and grief for lost time with loved one, (3) time as a gift and time as a burden and (4) positive legacy and challenging bereavement experience.

CONCLUSION

The nature of the MAiD experience for involved families is rooted in complexity, ambiguity and ambivalence and thus resists easy categorisation. Families would benefit from structured psychosocial and spiritual supports that acknowledge this complexity, along with MAiD-specific bereavement support following the death.

摘要

背景

那些陪伴亲人接受医疗协助死亡(MAiD)的人,在亲人去世后的很长时间里,都必须承受这种经历以及他们参与这一过程所带来的心理、道德和社会后果。

目的

探讨陪伴亲人经历医疗协助死亡过程的人在亲人死亡后的遗留影响。

设计

我们采用定性描述方法进行半结构化访谈,以收集陪伴亲人接受医疗协助死亡的家庭成员的数据。使用常规内容分析法对数据进行分析。

地点/参与者:14名在加拿大一家设有跨学科医疗协助死亡项目的医院接受医疗协助死亡的患者的16名家庭成员。

结果

分析中的主要主题是陪伴亲人经历医疗协助死亡的人所经历的相互对立的紧张关系,我们将其概念化为一种双刃剑体验。这种双刃剑体验通过四个主题性的对立紧张关系得以体现:(1)对患者自主权的支持与对医疗协助死亡选择的矛盾心理,(2)对亲人痛苦缓解的感激与对与亲人失去时光的悲痛,(3)时间是礼物与时间是负担,以及(4)积极的遗留影响与具有挑战性的丧亲经历。

结论

参与其中的家庭所经历的医疗协助死亡体验的性质源于复杂性、模糊性和矛盾心理,因此难以简单归类。家庭将受益于承认这种复杂性的结构化心理社会和精神支持,以及亲人去世后针对医疗协助死亡的丧亲支持。

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