Hospice Care Provider Perspectives of Medical Assistance in Dying in a Canadian Hospice That Does Not Provide Medical Assistance in Dying
Bibliographic record
Abstract
BACKGROUND: Medical assistance in Dying (MAiD) is offered across diverse settings, including hospices. There is little research exploring the experiences of hospice care providers who support patients who undergo MAiD at an off-site location. PURPOSE: To describe hospice care provider perceptions of MAiD in an in-patient hospice facility that does not provide MAiD. METHODS: Participants included hospice administrators, nurses, staff and volunteers who provide care at an in-patient hospice facility in a geographically isolated medium sized city (population <100,000) in a western Canadian province. Using a qualitative descriptive approach, eight in-depth semi-structured interviews were undertaken. Data were digitally recorded, transcribed, analyzed inductively, and organized thematically. RESULTS: Introduction of MAiD challenged and disrupted care practices. Themes included: Situating MAiD within hospice and palliative care, caring for patients undergoing MAiD within a non-provider facility, and balancing interpersonal dynamics in an interdisciplinary team environment. Themes were underpinned by participants' attempts to reconcile MAiD within personal beliefs and work environment. CONCLUSION: Caring for patients who chose MAiD changed the dynamic of care. Participants focused on providing patient-centred care while attempting to normalize the MAiD process. Educational resources to support patient-centred care for patients who undergo MAiD off-site, address care provider self-care, and to facilitate safe and effective interdisciplinary communication are needed.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".