Evidence map›Paper›PMID 37312178›Full record

ArticleBMC palliative care2023

The impact of COVID-19 on the experiences of patients and their family caregivers with medical assistance in dying in hospital.

Eryn Tong, Rinat Nissim, Debbie Selby, Sally Bean, Elie Isenberg-Grzeda, Tharshika Thangarasa, Gary Rodin, Madeline Li, Sarah Hales

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC palliative care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.9field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Eryn TongDepartment of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, Toronto, ON, Canada.
Rinat NissimDepartment of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, Toronto, ON, Canada.
Debbie SelbySunnybrook Health Sciences Centre, Toronto, ON, Canada.
Sally BeanSunnybrook Health Sciences Centre, Toronto, ON, Canada.
Elie Isenberg-GrzedaDepartment of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Tharshika ThangarasaDepartment of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, Toronto, ON, Canada.
Gary RodinDepartment of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, Toronto, ON, Canada.
Madeline LiDepartment of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, Toronto, ON, Canada.
Sarah HalesDepartment of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 620 University Avenue, Toronto, ON, Canada. sarah.hales@uhn.ca.
Princess Margaret Cancer Centre · CASunnybrook Health Science Centre · CAUniversity of Toronto · CAHealth Sciences Centre · CAUniversity Health Network · CA

Funding

Canadian Cancer Society 705663
6 · The paper itself

Abstract

backgroundThe COVID-19 pandemic and its containment measures have drastically impacted end-of-life and grief experiences globally, including those related to medical assistance in dying (MAiD). No known qualitative studies to date have examined the MAiD experience during the pandemic. This qualitative study aimed to understand how the pandemic impacted the MAiD experience in hospital of persons requesting MAiD (patients) and their loved ones (caregivers) in Canada.

methodsSemi-structured interviews were conducted with patients who requested MAiD and their caregivers between April 2020 and May 2021. Participants were recruited during the first year of the pandemic from the University Health Network and Sunnybrook Health Sciences Centre in Toronto, Canada. Patients and caregivers were interviewed about their experience following the MAiD request. Six months following patient death, bereaved caregivers were interviewed to explore their bereavement experience. Interviews were audio-recorded, transcribed verbatim, and de-identified. Transcripts were analyzed using reflexive thematic analysis.

resultsInterviews were conducted with 7 patients (mean [SD] age, 73 [12] years; 5 [63%] women) and 23 caregivers (mean [SD] age, 59 [11] years; 14 [61%] women). Fourteen caregivers were interviewed at the time of MAiD request and 13 bereaved caregivers were interviewed post-MAiD. Four themes were generated with respect to the impact of COVID-19 and its containment measures on the MAiD experience in hospital: (1) accelerating the MAiD decision; (2) compromising family understanding and coping; (3) disrupting MAiD delivery; and (4) appreciating rule flexibility.

conclusionsFindings highlight the tension between respecting pandemic restrictions and prioritizing control over the dying circumstances central to MAiD, and the resulting impact on patient and family suffering. There is a need for healthcare institutions to recognize the relational dimensions of the MAiD experience, particularly in the isolating context of the pandemic. Findings may inform strategies to better support those requesting MAiD and their families during the pandemic and beyond.

Indexed as

CaregiversCOVID-19AgedFemaleHospitalsHumansMaleMedical AssistanceMiddle AgedPandemicsAssisted dyingCanadaCOVID-19 pandemicMedical assistance in dyingQualitative research

Identifiers

PMID37312178
PMCPMC10261826
OpenAlexW4380577676

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.