美国法制化司法管辖区临终参与政策中面向公众的临终关怀医疗援助研究。

IF 2.1 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Todd D Becker, Paul Duberstein, Elizabeth A Luth, Sanjana Kumar, Samuel Nemeth, Kira Phillips, Veda Kota, Elissa Kozlov
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引用次数: 0

摘要

背景:在美国,每10名使用临终医疗援助(MAID)的患者中就有近9名参加了临终关怀。司法管辖区越来越多地要求卫生组织公开报告其MAID参与政策。然而,对美国临终关怀提供者中面向公众的MAID政策的流行程度和特征的全面检查是缺乏的。目的:本研究的目的是全面描述美国11个司法管辖区的临终关怀院面向公众的MAID参与政策的可得性和内容,其中MAID是合法的。设计:采用横断面设计。背景/对象:我们使用医疗保险和医疗补助服务中心的临终关怀-一般信息数据集来识别所有11个美国司法管辖区的医疗保险认证的临终关怀,其中MAID是合法的。测量:政策可用性通过是否有在线安宁疗护MAID参与政策来评估。政策内容被提取出来,以确定并随后对MAID参与的临床领域进行分类。结果:724家临终关怀医院中仅有39家(5.4%)公布了面向公众的MAID参与政策。即使在两个强制要求临终关怀在线出版的司法管辖区,政策可用性也很低(新墨西哥州52人中有0人[0.0%];加利福尼亚州389人中有14人[3.6%])。此外,即使在公布时,政策内容也变化很大,往往过于模糊,无法辨别哪些与妇幼保健有关的活动是允许的。例如,39份保单中有18份(46.2%)没有报告医生是否被允许开MAID药物。结论:临终关怀院面向公众的MAID参与政策缺乏可得性和特异性,可能危及患者获得合法的临终关怀选择。无论管辖权授权如何,都需要提高组织透明度,以支持知情决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Examining Public-Facing Hospice Medical Aid in Dying Participation Policies in Legalizing U.S. Jurisdictions.

Background: Nearly 9 in 10 patients in the United States who use medical aid in dying (MAID) are enrolled in hospice. Jurisdictions have increasingly mandated that health organizations publicly report their MAID participation policies. Yet comprehensive examination of the prevalence and characteristics of public-facing MAID policies in U.S. hospice providers is lacking. Objective: The objective of this study was to comprehensively characterize the availability and content of hospices' public-facing MAID participation policies in the 11 U.S. jurisdictions where MAID is legal. Design: We adopted a cross-sectional design. Setting/Subjects: We used the Centers for Medicare & Medicaid Services' Hospice - General Information data set to identify Medicare-certified hospices in all 11 U.S. jurisdictions where MAID is legal. Measurements: Policy availability was assessed via the presence or absence of online hospice MAID participation policies. Policy content was extracted to identify and subsequently categorize clinical domains of MAID participation. Results: Only 39 of 724 hospices (5.4%) published a public-facing MAID participation policy. Policy availability was low even within the two jurisdictions mandating hospice online publication (0 of 52 from New Mexico [0.0%]; 14 of 389 from California [3.6%]). Moreover, even when published, policy content was highly variable and often too vague to discern which MAID-related activities were permitted. For instance, 18 of 39 policies (46.2%) did not report whether or not physicians were permitted to prescribe MAID medication. Conclusions: The lack of availability and specificity in hospices' public-facing MAID participation policies may jeopardize patient access to legal end-of-life care options. Irrespective of jurisdictional mandates, greater organizational transparency is needed to support informed decision making.

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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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