Singer Jonathan, Breen Lauren J, Loggers Elizabeth T
Department of Psychological Sciences, Texas Tech University, Lubbock, TX.
Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
Palliat Support Care. 2023 Apr;21(2):270-276. doi: 10.1017/S1478951522000852.
Families bereaved following Medical Aid in Dying (MAID)-related death express concerns about public stigma. As access to MAID expands, research examining MAID is needed, including understanding stigma toward family members. This study examines if stigmatization exists toward bereaved individuals whose family member utilized MAID at differing ages and assess if expectations of grief differ between bereaved individuals whose family member utilized MAID compared to bereaved individuals whose family member died of an illness.
This study utilized a randomized, between-groups, vignette-based experiment to test the effects of cause of death (MAID vs. illness-related death) and age (28, 38, 70, and 80 years) of the deceased on indicators of public stigma. Participants ( = 428) were recruited from mTURK ( = 42.54; = 16.50).
Analyses showed a statistically significant interaction between age and the mode of death ((7, 400), = 0.001, $\eta _{\rm p}^2$ = 0.06) and the main effect for age ((5, 401), = 0.004, $\eta _{\rm p}^2$ = 0.04) on expectations of grief, whereas emotional reactions and wanting social distance were not significant ( > 0.05). Participants expected more maladaptive grief among family members of 28- and 70-year-olds who died of illness compared to 28- or 38-year-olds who utilized MAID [28-year-old ( = 44.12, = 12.03) or 70-year-old ( = 44.32, = 10.29) illness-related death vs. 28-year-old ( = 39.3, = 11.56; = 0.01) or 38-year-old ( = 38.71, = 11.56; = 0.007) MAID-related death].
Findings suggest that direct stigma does not exist toward family members of individuals engaging in MAID. The American public may expect that family members of young individuals who utilize MAID are accepting of the death and expect them to experience fewer maladaptive grief symptoms. Future research should investigate differences in bereavement outcomes based on age of bereaved caregivers of individuals engaging in MAID.
在因医疗协助死亡（MAID）相关死亡而痛失亲人的家庭中，家庭成员表达了对公众污名化的担忧。随着MAID适用范围的扩大，需要开展有关MAID的研究，包括了解对家庭成员的污名化情况。本研究探讨对于家庭成员在不同年龄使用MAID的丧亲者，是否存在污名化现象，并评估与家庭成员因病死亡的丧亲者相比，家庭成员使用MAID的丧亲者在悲伤预期方面是否存在差异。
本研究采用随机分组的基于 vignette 的实验，以测试死亡原因（MAID 与疾病相关死亡）和死者年龄（28 岁、38 岁、70 岁和 80 岁）对公众污名化指标的影响。参与者（n = 428）通过 mTURK 招募（M = 42.54；SD = 16.50）。
分析显示，年龄与死亡方式之间存在统计学上的显著交互作用（F(7, 400) = 4.78，p = 0.001，ηp2 = 0.06），年龄对悲伤预期有主效应（F(5, 401) = 4.43，p = 0.004，ηp2 = 0.04），而情绪反应和社交距离意愿不显著（p > 0.05）。与 28 岁或 38 岁使用 MAID 的丧亲者相比，参与者预计 28 岁和 70 岁因病死亡者的家庭成员会有更多适应不良的悲伤情绪[28 岁（M = 44.12，SD = 12.03）或 70 岁（M = 44.32，SD = 10.29）因病死亡者与 28 岁（M = 39.3，SD = 11.56；p = 0.01）或 38 岁（M = 38.71，SD = 11.56；p = 0.007）使用 MAID 的丧亲者相比]。
研究结果表明，对于参与 MAID 的个人的家庭成员不存在直接的污名化。美国公众可能预计，使用 MAID 的年轻人的家庭成员能够接受死亡，并预计他们经历的适应不良悲伤症状较少。未来的研究应调查参与 MAID 的个人的丧亲照顾者年龄对丧亲结果的差异。
