Characterizing Interdisciplinary U.S. Hospice Clinician Presence During Patient Self-Administration of Medical Aid in Dying Medication.

Abstract

Despite emerging as a clinical and scholarly focus in medical aid in dying (MAID)-related care, limited data exist to characterize hospice clinician presence while patients self-administer the medication to hasten their death. To explore (1) the proportion and (2) correlates of interdisciplinary hospice clinician presence during patient self-administration of MAID medication. Exploratory secondary analysis of cross-sectional survey data. Convenience sample of interdisciplinary U.S. hospice clinicians reporting permissive state and organizational MAID policy. We assessed the proportion of the sample ever having been present during patient self-administration of MAID medication via frequency and percentage. We examined personal, professional, organizational, and MAID-specific characteristics as correlates via multiple logistic regression analysis adjusted for small sample bias. Our sample included 100 hospice physicians, nurses, social workers, and chaplains. Descriptive results revealed that just over one-third of the sample had ever been present during patient self-administration of MAID medication. Regression results indicated that being a chaplain and working for a hospice with a policy permitting full MAID participation were each significantly associated with greater odds of ever having been present. Conversely, never having provided end-of-life care beyond information provision related to a hospice patient's use of MAID was significantly associated with lower odds of ever having been present. Hospice clinician presence during patient self-administration of MAID medication appears relatively common and related to select professional, organizational, and MAID-specific characteristics. Improved annual state reporting practices and expanded replication efforts are warranted.