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对临终医疗援助(女佣)进行立法审查。许多利益相关者都参与了对MAID的考虑。姑息治疗提供者(PCP)是最经常与患者就临终关怀进行沟通的医疗保健提供者。然而，关于女佣沟通的卫生服务研究却很少。我在哈佛医学院提出的研究项目旨在探索PCP对女佣沟通的看法。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他们的患者沟通有关女佣的问题？2)马萨诸塞州的姑息关怀提供者需要什么来充分解决患者关于女佣的询问？3)什么样的以患者为中心的文件形式，如开放的医疗记录或共享的录音，可以支持与处于姑息治疗中的女佣的沟通？为了探索这些问题，我计划对马萨诸塞州的初级保健医生进行为期六个月的横断面定性访谈研究。参与者将通过主办机构的姑息关怀网络通过滚雪球技术进行寻找。我计划进行15到20次采访，时长为30到45分钟。将使用定性内容分析对数据进行分析，并通过同行评议的国际期刊文章以及在团队会议和科学会议上的发言来传播数据。总体而言，该研究项目将提供对姑息治疗中女佣沟通现状的深入了解，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.