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“时机的关键界限”:对围绕医疗协助死亡的决策过程的现象学分析

"The Razor's Edge of Timing:" A Phenomenological Analysis of Decision-Making Processes Surrounding Medical Aid in Dying.

作者信息

Currin-McCulloch Jennifer, Gallo Nathan, Wang Yixuan, Mooney Kim

机构信息

School of Social Work, Colorado State University, Fort Collins, CO, United States.

Practically Dying, Inc., Longmont, CO, United States.

出版信息

Int J Public Health. 2024 Aug 30;69:1607435. doi: 10.3389/ijph.2024.1607435. eCollection 2024.

Abstract

OBJECTIVES

The study aimed to explore how terminally ill individuals in the United States approach medical aid in dying (MAID), including personal, interpersonal and structural factors that influence their decision-making processes.

METHODS

This embodied phenomenological study incorporated semi-structured (N = 9) interviews with seven terminally ill adults who received a prescription for MAID. Interviews occurred over Zoom between October 2021-January 2023 and was guided by Ashworth's framework for exploring phenomenological lifeworlds. Participants were invited to share perceptions of their lifeworlds in pursuit of MAID including values; embodied health, ability, and emotions; space and place in society; reflections on time/timing; and political and cultural discourse. Data analysis integrated Wertz's phenomenological psychological analysis methods.

RESULTS

The phenomenon of choosing MAID is an intricate juggling of lifeworlds between participants' embodied relationships, values, time and agency which lead to co-existing experiences of uncertainty and hard-won relief.

CONCLUSION

Our findings contribute cutting-edge knowledge of the decisional tensions and triumphs terminally ill individuals encounter as they approach MAID and highlight practical implications for health and mental health providers in preparing psychoeducational support for those seeking MAID.

摘要

目的

本研究旨在探讨美国晚期绝症患者如何寻求医疗协助死亡(MAID),包括影响其决策过程的个人、人际和结构因素。

方法

本项体现性现象学研究对7名接受MAID处方的晚期绝症成年人进行了半结构化访谈(N = 9)。访谈于2021年10月至2023年1月期间通过Zoom进行,并以阿什沃思探索现象学生活世界的框架为指导。参与者被邀请分享他们在寻求MAID过程中对生活世界的看法,包括价值观;身体的健康、能力和情感;在社会中的空间和位置;对时间/时机的思考;以及政治和文化话语。数据分析采用了韦尔茨的现象学心理分析方法。

结果

选择MAID这一现象是参与者在身体关系、价值观、时间和能动性之间对生活世界进行复杂权衡的结果,这导致了不确定性和来之不易的解脱并存的体验。

结论

我们的研究结果为晚期绝症患者在寻求MAID时所面临的决策紧张和胜利提供了前沿知识,并突出了对健康和心理健康提供者为寻求MAID者提供心理教育支持的实际意义。

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