The Impact of Legalizing Medical Aid in Dying on Patient Trust: A Randomized Controlled Survey Study.

IF 2.2 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Journal of palliative medicine Pub Date : 2024-11-01 Epub Date: 2024-08-21 DOI:10.1089/jpm.2023.0706
Jessica B Anderson, Maria Cacciapuoti, Hannah Day, Taymour Hashemzadeh, Benjamin J Krohmal
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Abstract

Background: Some commentators and several professional medical associations have expressed concern that legalizing medical aid in dying ("MAID") will undermine patient trust in the medical profession, particularly among historically disadvantaged patient populations. While this concern remains influential, it has been subject to limited empirical scrutiny. Objectives: This study aims to empirically assess whether MAID legalization undermines patient trust, with considerations of potential trust/demographic correlations in marginalized and minority patient populations. Design: We developed an RCT survey study that assessed patients' trust in the medical professional using the Abbreviated Wake Forest Scale ("AWFS"). Two versions of the survey were used, each distributed at random to half of participants. One survey version included notification that MAID had been legalized in the jurisdiction where patients were receiving care and the other version omitted this information. Setting/Population: We surveyed capacitated, English-speaking adult patients who were receiving care at a not-for-profit, 912-bed academic and research hospital in Washington, D.C. Of those invited to participate, 494 patients (63.2%) completed all AWFS questions, and 70.1% identified as Black or African American and 32.9% as having a physical or mental disability. Conclusions: Most of the participants not notified that MAID was legal in DC were not aware of this fact (92.5%). Patients who were notified that MAID was legal in DC were significantly more likely to report approval of MAID legalization (p = 0.0410), but showed no significant difference in AWFS score for trust in their physicians. The study did not substantiate concerns that legalizing medical aid in dying undermines patient trust in the medical profession.

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临终医疗援助合法化对患者信任的影响:随机对照调查研究
背景:一些评论家和一些专业医疗协会担心,将临终医疗援助(MAID)合法化会破坏病人对医疗行业的信任,尤其是在历史上处于弱势地位的病人群体中。尽管这种担忧仍有影响力,但对其进行的实证审查却十分有限。研究目的:本研究旨在通过实证研究评估 MAID 合法化是否会损害患者的信任,同时考虑边缘化和少数民族患者群体中潜在的信任/人口统计学相关性。设计:我们制定了一项 RCT 调查研究,使用缩写维克森林量表("AWFS")评估患者对医务人员的信任度。我们使用了两个版本的调查表,每个版本都随机分发给一半的参与者。其中一个调查版本包含患者接受治疗的司法管辖区已将 MAID 合法化的通知,而另一个版本则省略了这一信息。环境/人群:我们调查了在华盛顿特区一家拥有 912 张床位的非营利性学术研究医院接受治疗的有能力、讲英语的成年患者。在受邀参与调查的患者中,494 名患者(63.2%)完成了所有 AWFS 问题,70.1% 的患者自称是黑人或非裔美国人,32.9% 的患者自称有身体或精神残疾。结论:大多数未被告知 MAID 在华盛顿州合法的参与者并不知道这一事实(92.5%)。获得 MAID 在华盛顿州合法化通知的患者更有可能表示同意 MAID 合法化(p = 0.0410),但在对医生的信任度 AWFS 分数上没有明显差异。该研究并未证实临终关怀合法化会破坏患者对医疗行业信任的担忧。
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来源期刊
Journal of palliative medicine
Journal of palliative medicine 医学-卫生保健
CiteScore
3.90
自引率
10.70%
发文量
345
审稿时长
2 months
期刊介绍: Journal of Palliative Medicine is the premier peer-reviewed journal covering medical, psychosocial, policy, and legal issues in end-of-life care and relief of suffering for patients with intractable pain. The Journal presents essential information for professionals in hospice/palliative medicine, focusing on improving quality of life for patients and their families, and the latest developments in drug and non-drug treatments. The companion biweekly eNewsletter, Briefings in Palliative Medicine, delivers the latest breaking news and information to keep clinicians and health care providers continuously updated.
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