Journal article
Interdisciplinary US Hospice Clinician Presence Throughout the Medical Aid in Dying Procedure
Journal of pain and symptom management, Vol.71(4), pp.464-4720
04/2026
DOI: 10.1016/j.jpainsymman.2025.11.023
PMCID: PMC13007664
PMID: 41354329
Abstract
Although hospice policies vary in where they permit staff to be physically located during key stages of the medical aid in dying (MAID) procedure, data needed to inform best practices concerning if and how clinicians themselves are present are lacking.
To (1) assess the sample proportion of clinician presence during each individual stage of the MAID procedure and (2) typologize the distinct trajectories of clinician presence across stages of the MAID procedure.
We used secondary cross-sectional survey data from a convenience sample of interdisciplinary US hospice clinicians indicating permissive state and organizational MAID participation policies. Participants reported whether they had ever been present during medication self-administration, after medication self-administration, and after death by indicating if they had been in the same room, in the same residence but not the same room, or never present. We assessed presence and typologized trajectories via frequency and percentage.
The sample comprised 106 hospice physicians, nurses, social workers, and chaplains. The sample majority reported never having been present during any stage. Across stages, the sample demonstrated 13 distinct trajectories of clinician presence. The most common trajectories illustrated uniformity in physical location across stages. The remaining trajectories reflected transitions in physical locations across stages. Transition subgroups depicted increasing proximity to bedside, increasing distance from bedside, and a combination of both.
High variability in hospice clinician presence throughout the MAID procedure may differentially affect patient care. Future best-practices research should explore stakeholder experiences of trajectories and stratify trajectories by professional discipline.
Details
- Title: Subtitle
- Interdisciplinary US Hospice Clinician Presence Throughout the Medical Aid in Dying Procedure
- Creators
- Todd D. Becker - Washington University in St. Louis School of MedicineKarla T. Washington - Washington University in St. Louis School of MedicineElissa Kozlov - Rutgers University–NewarkDenae J. Gerasta - Colorado School of Public HealthGrant Yoder - University of Colorado Anschutz Medical CampusDaniel D. Matlock - University of Colorado Anschutz Medical CampusStacy M. Fischer - University of Colorado Anschutz Medical CampusSara Sanders - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of pain and symptom management, Vol.71(4), pp.464-4720
- DOI
- 10.1016/j.jpainsymman.2025.11.023
- PMID
- 41354329
- PMCID
- PMC13007664
- NLM abbreviation
- J Pain Symptom Manage
- ISSN
- 0885-3924
- eISSN
- 1873-6513
- Publisher
- Elsevier Inc; NEW YORK
- Grant note
- Hospice Foundation of AmericaUniversity of Maryland School of Social Work PhD ProgramNational Cancer Institute of the National Institutes of Health: T32CA190194
This project received funding from the Hospice Foundation of America and the University of Maryland School of Social Work PhD Program. Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under award number T32CA190194. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. We thank Dr Kyle Pitzer for his assistance with data visualization.
- Language
- English
- Electronic publication date
- 12/05/2025
- Date published
- 04/2026
- Academic Unit
- Liberal Arts and Science Admin; School of Social Work
- Record Identifier
- 9985090585502771
Metrics
2 Record Views