Matters about life and death: A qualitative exploration of palliative care providers’ communication about medical assistance in dying

德国和马萨诸塞州目前正在立法审查临终医疗援助（MAID）。许多利益相关者都在考虑MAID。姑息治疗提供者（pcp）是最经常与患者沟通临终关怀的医疗保健提供者。然而，卫生服务机构对MAID的传播研究较少。我在哈佛医学院提出的研究项目旨在探索pcp对MAID沟通的看法。该项目将解决以下研究问题：1)马萨诸塞州的姑息治疗提供者如何与患者沟通MAID？2)马萨诸塞州的姑息治疗提供者需要如何充分解决患者对MAID的询问？3)哪些以患者为中心的文件形式（如开放病历或共享录音）可以支持姑息治疗中MAID的沟通？为了探索这些问题，我计划对马萨诸塞州的pcp进行为期六个月的横断面定性访谈研究。参与者将通过滚雪球技术通过主办机构的姑息治疗网络寻求。我计划进行15到20次采访，每次采访时间为30到45分钟。数据将采用定性内容分析进行分析，并通过同行评议的国际期刊文章和在小组会议和科学会议上的报告进行传播。总体而言，该研究项目将提供对姑息治疗中MAID传播现状的深入了解，并确定对研究、政策和实践的影响。

Medical assistance in dying (MAID) is currently under legislative review in Germany and Massachusetts. Many stakeholders are involved in considerations about MAID. Palliative care providers (PCPs) are the healthcare providers most routinely communicating with patients about end-of-life care. However, health services research on communication about MAID is sparse. My proposed research project at the Harvard Medical School aims to explore PCPs’ perspectives on communication about MAID. The project will address the following research questions: 1) How do palliative care providers in Massachusetts communicate with their patients about MAID? 2) What do palliative care providers in Massachusetts need to adequately address patients’ inquiries about MAID? 3) What forms of patient-centered documentation such as open medical records or shared audio recordings could support communication about MAID in palliative care? To explore these questions, I plan to conduct a cross-sectional qualitative interview study over six months with PCPs in Massachusetts. Participants will be sought through snowballing technique via the host institution’s palliative care network. I plan to conduct 15 to 20 interviews with a duration of 30 to 45 minutes. Data will be analyzed using qualitative content analysis and disseminated through a peer-reviewed international journal article and presentations at team meetings and scientific conferences. Overall, the research project will provide an advanced understanding of the current state of communication about MAID in palliative care and identify implications for research, policy, and practice.