“The Razor’s Edge of Timing:” A Phenomenological Analysis of Decision-Making Processes Surrounding Medical Aid in Dying

Abstract

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ObjectivesThe study aimed to explore how terminally ill individuals in the United States approach medical aid in dying (MAID), including personal, interpersonal and structural factors that influence their decision-making processes.MethodsThis embodied phenomenological study incorporated semi-structured (N = 9) interviews with seven terminally ill adults who received a prescription for MAID. Interviews occurred over Zoom between October 2021-January 2023 and was guided by Ashworth’s framework for exploring phenomenological lifeworlds. Participants were invited to share perceptions of their lifeworlds in pursuit of MAID including values; embodied health, ability, and emotions; space and place in society; reflections on time/timing; and political and cultural discourse. Data analysis integrated Wertz’s phenomenological psychological analysis methods.ResultsThe phenomenon of choosing MAID is an intricate juggling of lifeworlds between participants’ embodied relationships, values, time and agency which lead to co-existing experiences of uncertainty and hard-won relief.ConclusionOur findings contribute cutting-edge knowledge of the decisional tensions and triumphs terminally ill individuals encounter as they approach MAID and highlight practical implications for health and mental health providers in preparing psychoeducational support for those seeking MAID.

Keywords

• values
• medical aid in dying
• phenomenology
• end-of-life decision making
• timing