| Medical aid in dying (MAiD) consists of clinicians helping terminally ill persons seek, and if eligible, complete a medically assisted death. It is increasingly legal across the United States with two states no longer requiring residency. Although opinion polls often show most Americans believe MAiD should be legal, the practice remains controversial in social work, medicine, and disability studies. Opponents of it worry about abuse, coercion, and a culture change that could lead to further devaluing disabled lives, while proponents hail MAiD as providing autonomy and choice. This dissertation sought to explore MAiD caregiver's and advocates' (n = 3), and physicians’ experiences (n = 20), practices, and beliefs using ethnographic methods of narrative and semi-structured interviewing, participant observation, and archival review. Analyses are presented in three stand-alone chapters: The first incorporates the case study of an MAiD caregiver, information, and resources into difficult decisions and situations surrounding both hastened and unhastened deaths. The second chapter features an analysis of data regarding times from ingestion to death in MAiD. Here, physicians describe good care as shortening clock times or subjective times to death by identifying and re-placing agencies; and capacities to act, rather than identifying individual autonomy. The third chapter presents MAiD physician practice themes and discusses overlap with end-of-life social work roles, marshaling data addressing MAiD discussions, hospice support, and family needs during the death vigil to show that social work needs to move beyond the focus of ethics to MAiD practice. Finally, the implications of this research are discussed and future research topics relevant to both anthropology and social work are proposed. |
