Variath Caroline, Climans Seth A, Edelstein Kim, Bell Jennifer A H
Lawrence S Bloomberg School of Nursing, Joint Centre for Bioethics, University of Toronto, Toronto, Canada.
Departments of Neurology and Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada.
Death Stud. 2023;47(3):296-306. doi: 10.1080/07481187.2022.2063456. Epub 2022 Apr 20.
In most jurisdictions where medical assistance in dying (MAiD) is legal, patients must have decision-making capacity. Brain cancer often damages the cognitive networks required to maintain decision-making capacity. Using qualitative methodology guided by a relational ethics conceptual framework, this study explored neuro-oncology clinicians' perspectives on access to and eligibility for MAiD for patients diagnosed with brain cancer. We interviewed 24 neuro-oncology clinicians from 6 countries. Participants described the unique challenges facing brain cancer patients, potentially resulting in their inequitable access to MAiD. The findings highlight the importance of early end-of-life conversations, advance care planning, and access to end-of-life treatment options.
在大多数医疗协助死亡（MAiD）合法的司法管辖区，患者必须具备决策能力。脑癌常常会损害维持决策能力所需的认知网络。本研究采用以关系伦理概念框架为指导的定性方法，探讨了神经肿瘤学临床医生对于被诊断患有脑癌的患者获得MAiD的机会和资格的看法。我们采访了来自6个国家的24名神经肿瘤学临床医生。参与者描述了脑癌患者面临的独特挑战，这可能导致他们在获得MAiD方面存在不公平现象。研究结果凸显了早期临终谈话、预先护理规划以及获得临终治疗选择的重要性。
