What About Us? Experiences of Relatives Regarding Physician-Assisted Death for Patients Suffering from Mental Illness: A Qualitative Study

Pronk, Rosalie; Willems, Dick L.; Vathorst, Suzanne van de

doi:10.1007/s11013-021-09762-1

Cited by 9 publications

(20 citation statements)

References 12 publications

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“…Most studies were published in Canada (n=15) 6 23–36. Other jurisdictions included Switzerland (n=3),37–39 Netherlands (n=3),16 40 41 USA (n=2),42 43 Australia44 or multiple jurisdictions or not specified (n=4) 5 7 10 32 45. Of the 22 identified empirical studies, almost half employed exploratory qualitative methodology (n=13),23–26 28 30 31 33 34 36 37 43 44 with the remainder being either observational quantitative studies (n=6)29 38–40 42 44 or mixed-methods studies (n=3) 6 27 35.…”

Section: Resultsmentioning

confidence: 99%

“…There were five studies that included the perspectives of HCPs on a family/friend’s bereavement, with two studies30 33 including only physicians, nurses, case workers and social workers, and another study29 including only physicians. A few studies had specific research questions regarding a MAiD patient subpopulation or the setting of MAiD: Swarte et al 40 focused on MAiD within the context of patients with cancer; Hashemi et al 6 studied MAiD cases which took place at home; and Pronk et al 41 studied family/friends of patients with mental health in relation to MAiD. There were four studies34 35 40 42 that compared family/friend’s bereavements of those who received MAiD and those who did not.…”

Section: Resultsmentioning

confidence: 99%

“…The interactions and the development of relationships over time can largely impact how family/friends experience grief. The defining relationship is often between family/friends and the patient,34 41 but interactions with HCPs can be impactful.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Grief and bereavement of family and friends around medical assistance in dying: scoping review

Yan

Bytautas

Isenberg

et al. 2022

BMJ Support Palliat Care

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ObjectivesThe increase in the number of jurisdictions legalising medical assistance in dying (MAiD) has contributed to a growth in the number of family and friends who may face unique elements of grief and bereavement. The aim of this study was to review the literature of grief and bereavement of family and friends following MAiD, and to summarise findings for the development of community resources and programming.MethodsWe performed a scoping review with workshop consultation of stakeholders. Six electronic databases and the grey literature were searched for qualitative, quantitative and review articles. Content-analytical techniques and multidisciplinary discussions led to the development of concepts and a conceptual framework.ResultsTwenty-eight articles met the inclusion criteria. We identified five concepts that impact the grief and bereavement of family/friends: relationships between family/friends and the patient as well as healthcare providers; aspects of MAiD grief which can include secrecy and/or anticipatory grief; preparations which may include family/friends and should be centralised and harmonised; end of life as an opportunity for ceremony; and the aftereffects during which mental health outcomes are studied.ConclusionThis multidisciplinary scoping review incorporates stakeholder consultation to find that support is needed to address the complicated and changing emotions of family/friends before, during and after a MAiD death. Furthermore, additional societal normalisation of MAiD is necessary to reduce secrecy and stigma and improve the accessibility of resources for family/friends.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Grief and bereavement of family and friends around medical assistance in dying: scoping review

Yan

Bytautas

Isenberg

et al. 2022

BMJ Support Palliat Care

View full text Add to dashboard Cite

show abstract

“…Also, given that these euthanasia trajectories and their outcomes affect so many actors directly or indirectly involved, future focus group studies bringing both the patient population and the health care team, including the patients social inner circle, together, may elucidate how and to what extent one can address and meet other actors' needs. Particularly the perspective of patients' social inner circle is missing, while a Dutch study found a considerable role in and impact of the euthanasia trajectory for them ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

Concrete Experiences and Support Needs Regarding the Euthanasia Practice in Adults With Psychiatric Conditions: A Qualitative Interview Study Among Healthcare Professionals and Volunteers in Belgium

et al. 2022

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ObjectiveAlthough euthanasia in the context of adult psychiatry is legalized in Belgium, it poses major ethical and clinical challenges for the health care professionals and volunteers involved. This study aimed to address these members' concrete experiences and support needs.MethodsA qualitative semi-structured interview study was conducted with 16 physicians and 14 other health care professionals and volunteers, with at least one concrete experience with euthanasia requests and procedures concerning adults with psychiatric conditions.FindingsConcrete experiences concerned the following 8 domains: (1) the impact of euthanasia on the clinical trajectory and (2) on the therapeutic relationship, (3) internal and (4) external collaborative partnerships, (5) patients' social inner circle (non-)involvement, (6) the use of recently published guidelines and, (7) the first criminal trials on this topic, and (8) the act of euthanasia. The following 8 main support needs emerged; (1) protocols addressing specific sub-populations and pathologies, (2) protocols specifically drawn up for non-medics, (3) guidance on how to adequately implement the two-track approach, (4) (after)care for patients, (5) (after)care for the health care team, (6) guidance on the patient's social inner circle involvement, (7) enhanced education measures, and (8) enhanced financial measures, including incentives for holistic, palliative care approaches.ConclusionThe health care professionals and volunteers reported many positive and negative experiences in dealing with euthanasia requests in adult psychiatry. They reported several support needs across the extensive euthanasia trajectory, pertaining to concrete management of thorny issues that guidelines do not (yet) touch on. Important implications of our study relate to tackling these existing issues, and to paying sufficient attention to the impact of a euthanasia trajectory on all actors, including the patients and their social inner circle, involved.

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“…While there is literature about MAiD examining caregivers and family relatives of patients with terminal somatic illness [34], there are only very few studies on families of patients with psychiatric disorders. A qualitative Dutch study showed that although the relatives of psychiatric patients were understanding of their wish to die (e.g., compassion, respect for autonomy, fear that the patient will commit a gruesome suicide), they also hoped that they would make another choice [35].…”

Section: Opinions and Attitudes Of Relatives Of Patients With Psychia...mentioning

confidence: 99%

Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders

Grassi

Folesani

Marella

et al. 2022

Curr Psychiatry Rep

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Purpose of Review Over the last 30 years, medical assistance in dying (MAiD) including euthanasia (EU) and physician-assisted death (or suicide, PAS) has become the center of a large debate, particularly when these practices have involved people with psychiatric illness, including resistant depression, schizophrenia, personality, or other severe psychiatric disorders. We performed a review utilizing several databases, and by including the most relevant studies in full journal articles investigating the problem of MAiD in patients with psychiatric disorders but not in physical terminal conditions (non-terminal, MAiD-NT). Recent Findings Literature has shown that a small percentage of people with psychiatric disorders died by MAiD-NT in comparison with patients with somatic diseases in terminal clinical conditions (e.g., cancer, AIDS). However, the problem in the field is complex and not solved yet as confirmed by the fact that only a few countries (e.g., the Netherlands, Belgium, Luxemburg) have legalized MAiD-NT for patients with psychiatric disorders, while most have maintained the practices accessible only to people with somatic disease in a terminal phase. Also, how to make objective the criterion of irremediability of a mental disorder; how to balance suicide prevention with assisted suicide; how to avoid the risk of progressively including in requests for MAiD-NT vulnerable segments of the population, such as minors, elderly, or people with dementia, in a productive-oriented society, are some of the critical points to be discussed. Summary The application of MAiD-NT in people with psychiatric disorders should be further explored to prevent end-of-life rights from contradicting the principles of recovery-oriented care.

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What About Us? Experiences of Relatives Regarding Physician-Assisted Death for Patients Suffering from Mental Illness: A Qualitative Study

Cited by 9 publications

References 12 publications

Grief and bereavement of family and friends around medical assistance in dying: scoping review

Grief and bereavement of family and friends around medical assistance in dying: scoping review

Concrete Experiences and Support Needs Regarding the Euthanasia Practice in Adults With Psychiatric Conditions: A Qualitative Interview Study Among Healthcare Professionals and Volunteers in Belgium

Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders

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