Medical Aid in Dying: Developing Communication Strategies, Staff Support Systems, and Policy for Hospices

• Published in: Journal of pain and symptom management Vol. 67; no. 5; p. e577
• Main Authors: VandeKieft, Gregg, Estep, Leslie A., Davis, Kathryn A., Wechkin, Hope, Meyer, Anita
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-05-2024
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2024.02.380

1. Participants will be able to demonstrate effective communication strategies for hospice clinicians to elicit patients' concerns and hopes when they inquire about medical aid in dying.
2. Participants will be able to describe resources to support staff experiencing moral distress around medical aid in dying and to craft educational resources and policy to guide hospice staff when patients inquire about medical aid in dying.
Approximately 20% of Americans reside in a jurisdiction where Medical Aid in Dying (MAID) is legal. Hospices have an obligation to provide high-quality care for patients pursuing this option, whether the hospice directly participate in MAID or not. The session will review the development of hospice policy, patient and staff support, and educational resources regarding MAID.
Nearly one in five Americans live in a jurisdiction with legalized medical aid in dying (MAID), i.e., the ability for a competent, terminally ill patient to request a prescription for a lethal drug combination with the intent to end their life at a time of their choosing rather, than awaiting death from their terminal illness. Because U.S. statutes governing MAID require two providers to attest that the patient has a life expectancy of 6 months or less, patients eligible for MAID are also hospice eligible and the overwhelming majority patients who pursue MAID are receiving hospice care. Hospices have an obligation to support both patients and staff when MAID is being considered. Specific responsibilities include effectively communicating when a patient inquires about MAID, addressing the moral weight that hospice staff may experience when encountering this subject, and developing clear organizational guidelines. Medical directors for two hospice agencies, one within a large Catholic health system which does not directly participate in MAID and one without religious affiliation which does directly participate, will provide an overview of how their agencies and health system drafted policies, communication strategies, and resources to support patients, families, and hospice staff when a patient is considering MAID. A social worker within the non-religiously affiliated hospice will provide additional perspective on the operational aspects of a fully participating hospice program. Each presenter was centrally involved in developing their agency and health system's policy, protocols, communication strategies, and support resources.
Advocacy / Policy / Regulations / Interdisciplinary Teamwork / Professionalism