What’s suffering got to do with it? A qualitative study of suffering in the context of Medical Assistance in Dying (MAID)

Abstract Background Intolerable suffering is a common eligibility requirement for persons requesting assisted death, and although suffering has received philosophic attention for millennia, only recently has it been the focus of empirical inquiry. Robust theoretical knowledge about suffering is crit...

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Autores principales:	Barbara Pesut, David Kenneth Wright, Sally Thorne, Margaret I. Hall, Gloria Puurveen, Janet Storch, Madison Huggins
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Suffering Palliative care Assisted death Medical assistance in dying End of life Nursing Special situations and conditions RC952-1245
Acceso en línea:	https://doaj.org/article/4ea98cecbc234e00a2030445df0db48c
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spelling	oai:doaj.org-article:4ea98cecbc234e00a2030445df0db48c2021-11-14T12:11:56ZWhat’s suffering got to do with it? A qualitative study of suffering in the context of Medical Assistance in Dying (MAID)10.1186/s12904-021-00869-11472-684Xhttps://doaj.org/article/4ea98cecbc234e00a2030445df0db48c2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12904-021-00869-1https://doaj.org/toc/1472-684XAbstract Background Intolerable suffering is a common eligibility requirement for persons requesting assisted death, and although suffering has received philosophic attention for millennia, only recently has it been the focus of empirical inquiry. Robust theoretical knowledge about suffering is critically important as modern healthcare provides persons with different options at end-of-life to relieve suffering. The purpose of this paper is to present findings specific to the understanding and application of suffering in the context of MAID from nurses’ perspectives. Methods A longitudinal qualitative descriptive study using semi-structured telephone interviews. Inductive analysis was used to construct a thematic account. The study received ethical approval and all participants provided written consent. Results Fifty nurses and nurse practitioners from across Canada were interviewed. Participants described the suffering of dying and provided insights into the difficulties of treating existential suffering and the iatrogenic suffering patients experienced from long contact with the healthcare system. They shared perceptions of the suffering that leads to a request for MAID that included the unknown of dying, a desire for predictability, and the loss of dignity. Eliciting the suffering story was an essential part of nursing practice. Knowledge of the story allowed participants to find the balance between believing that suffering is whatever the persons says it is, while making sure that the MAID procedure was for the right person, for the right reason, at the right time. Participants perceived that the MAID process itself caused suffering that resulted from the complexity of decision-making, the chances of being deemed ineligible, and the heighted work of the tasks of dying. Conclusions Healthcare providers involved in MAID must be critically reflective about the suffering histories they bring to the clinical encounter, particularly iatrogenic suffering. Further, eliciting the suffering stories of persons requesting MAID requires a high degree of skill; those involved in the assessment process must have the time and competency to do this important role well. The nature of suffering that patients and family encounter as they enter the contemplation, assessment, and provision of MAID requires further research to understand it better and develop best practices.Barbara PesutDavid Kenneth WrightSally ThorneMargaret I. HallGloria PuurveenJanet StorchMadison HugginsBMCarticleSufferingPalliative careAssisted deathMedical assistance in dyingEnd of lifeNursingSpecial situations and conditionsRC952-1245ENBMC Palliative Care, Vol 20, Iss 1, Pp 1-15 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Suffering Palliative care Assisted death Medical assistance in dying End of life Nursing Special situations and conditions RC952-1245
spellingShingle	Suffering Palliative care Assisted death Medical assistance in dying End of life Nursing Special situations and conditions RC952-1245 Barbara Pesut David Kenneth Wright Sally Thorne Margaret I. Hall Gloria Puurveen Janet Storch Madison Huggins What’s suffering got to do with it? A qualitative study of suffering in the context of Medical Assistance in Dying (MAID)
description	Abstract Background Intolerable suffering is a common eligibility requirement for persons requesting assisted death, and although suffering has received philosophic attention for millennia, only recently has it been the focus of empirical inquiry. Robust theoretical knowledge about suffering is critically important as modern healthcare provides persons with different options at end-of-life to relieve suffering. The purpose of this paper is to present findings specific to the understanding and application of suffering in the context of MAID from nurses’ perspectives. Methods A longitudinal qualitative descriptive study using semi-structured telephone interviews. Inductive analysis was used to construct a thematic account. The study received ethical approval and all participants provided written consent. Results Fifty nurses and nurse practitioners from across Canada were interviewed. Participants described the suffering of dying and provided insights into the difficulties of treating existential suffering and the iatrogenic suffering patients experienced from long contact with the healthcare system. They shared perceptions of the suffering that leads to a request for MAID that included the unknown of dying, a desire for predictability, and the loss of dignity. Eliciting the suffering story was an essential part of nursing practice. Knowledge of the story allowed participants to find the balance between believing that suffering is whatever the persons says it is, while making sure that the MAID procedure was for the right person, for the right reason, at the right time. Participants perceived that the MAID process itself caused suffering that resulted from the complexity of decision-making, the chances of being deemed ineligible, and the heighted work of the tasks of dying. Conclusions Healthcare providers involved in MAID must be critically reflective about the suffering histories they bring to the clinical encounter, particularly iatrogenic suffering. Further, eliciting the suffering stories of persons requesting MAID requires a high degree of skill; those involved in the assessment process must have the time and competency to do this important role well. The nature of suffering that patients and family encounter as they enter the contemplation, assessment, and provision of MAID requires further research to understand it better and develop best practices.
format	article
author	Barbara Pesut David Kenneth Wright Sally Thorne Margaret I. Hall Gloria Puurveen Janet Storch Madison Huggins
author_facet	Barbara Pesut David Kenneth Wright Sally Thorne Margaret I. Hall Gloria Puurveen Janet Storch Madison Huggins
author_sort	Barbara Pesut
title	What’s suffering got to do with it? A qualitative study of suffering in the context of Medical Assistance in Dying (MAID)
title_short	What’s suffering got to do with it? A qualitative study of suffering in the context of Medical Assistance in Dying (MAID)
title_full	What’s suffering got to do with it? A qualitative study of suffering in the context of Medical Assistance in Dying (MAID)
title_fullStr	What’s suffering got to do with it? A qualitative study of suffering in the context of Medical Assistance in Dying (MAID)
title_full_unstemmed	What’s suffering got to do with it? A qualitative study of suffering in the context of Medical Assistance in Dying (MAID)
title_sort	what’s suffering got to do with it? a qualitative study of suffering in the context of medical assistance in dying (maid)
publisher	BMC
publishDate	2021
url	https://doaj.org/article/4ea98cecbc234e00a2030445df0db48c
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What’s suffering got to do with it? A qualitative study of suffering in the context of Medical Assistance in Dying (MAID)

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