Contextualizing attitudes toward medical aid in dying in a national sample of interdisciplinary US hospice clinicians: hospice philosophy of care, patient-centered care, and professional exposure
Background: Despite extensive theoretical debate, empirical research on medical aid in dying (MAID) largely has disregarded broader, contextual factors as potential correlates of attitudes in hospice clinicians. Objective: Informed by institutional theory and neofunctional attitude theory, the objec...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2024-12-01
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| Series: | Palliative Care and Social Practice |
| Online Access: | https://doi.org/10.1177/26323524241302097 |
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| author | Todd D. Becker John G. Cagle Cindy L. Cain Joan K. Davitt Nancy Kusmaul Paul Sacco |
| author_facet | Todd D. Becker John G. Cagle Cindy L. Cain Joan K. Davitt Nancy Kusmaul Paul Sacco |
| author_sort | Todd D. Becker |
| collection | DOAJ |
| description | Background: Despite extensive theoretical debate, empirical research on medical aid in dying (MAID) largely has disregarded broader, contextual factors as potential correlates of attitudes in hospice clinicians. Objective: Informed by institutional theory and neofunctional attitude theory, the objective of the current study was to quantitatively examine hospice clinicians’ attitudes toward MAID as functions of institutional characteristics relating to (Aim 1) individual adherence to hospice values and (Aim 2) state law. Design: We used a cross-sectional design. Methods: A national convenience sample of interdisciplinary hospice clinicians recruited through US professional membership associations self-administered an online survey. Measures included attitudes toward MAID, attitudes toward the hospice philosophy of care, attitudes toward the principle that hospice care should not hasten death, orientation toward patient-centeredness, professional exposure to working in a state where MAID is legal, and demographic characteristics. Data were analyzed via a partial proportional odds model. Results: The sample ( N = 450) comprised hospice physicians (227 [50.4%]), nurses (64 [14.2%]), social workers (74 [16.4%]), and 85 chaplains (85 [18.9%]). Results of the partial proportional odds model indicated that professional exposure to working in a state where MAID is legal was significantly associated with over twice the cumulative odds of MAID support. Although neither orientation toward patient-centered care nor attitudes toward the hospice philosophy of care was significantly associated with attitudes toward MAID, results showed that disagreement with the narrower principle that hospice care should not hasten death was significantly associated with 6-to-7 times the cumulative odds of MAID support. Conclusion: Findings suggest that contextual factors—namely, the environments in which hospice clinicians practice—may shape attitudes toward MAID. Unanticipated results indicating that hospice professionals’ adherence to hospice values was not significantly associated with attitudes toward MAID underscore the need for further research on these complex associations, given previous theoretical and empirical support. |
| format | Article |
| id | doaj-art-29f83ccef66a4c138857b7fc0e2b3716 |
| institution | Kabale University |
| issn | 2632-3524 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Palliative Care and Social Practice |
| spelling | doaj-art-29f83ccef66a4c138857b7fc0e2b37162025-01-06T09:03:21ZengSAGE PublishingPalliative Care and Social Practice2632-35242024-12-011810.1177/26323524241302097Contextualizing attitudes toward medical aid in dying in a national sample of interdisciplinary US hospice clinicians: hospice philosophy of care, patient-centered care, and professional exposureTodd D. BeckerJohn G. CagleCindy L. CainJoan K. DavittNancy KusmaulPaul SaccoBackground: Despite extensive theoretical debate, empirical research on medical aid in dying (MAID) largely has disregarded broader, contextual factors as potential correlates of attitudes in hospice clinicians. Objective: Informed by institutional theory and neofunctional attitude theory, the objective of the current study was to quantitatively examine hospice clinicians’ attitudes toward MAID as functions of institutional characteristics relating to (Aim 1) individual adherence to hospice values and (Aim 2) state law. Design: We used a cross-sectional design. Methods: A national convenience sample of interdisciplinary hospice clinicians recruited through US professional membership associations self-administered an online survey. Measures included attitudes toward MAID, attitudes toward the hospice philosophy of care, attitudes toward the principle that hospice care should not hasten death, orientation toward patient-centeredness, professional exposure to working in a state where MAID is legal, and demographic characteristics. Data were analyzed via a partial proportional odds model. Results: The sample ( N = 450) comprised hospice physicians (227 [50.4%]), nurses (64 [14.2%]), social workers (74 [16.4%]), and 85 chaplains (85 [18.9%]). Results of the partial proportional odds model indicated that professional exposure to working in a state where MAID is legal was significantly associated with over twice the cumulative odds of MAID support. Although neither orientation toward patient-centered care nor attitudes toward the hospice philosophy of care was significantly associated with attitudes toward MAID, results showed that disagreement with the narrower principle that hospice care should not hasten death was significantly associated with 6-to-7 times the cumulative odds of MAID support. Conclusion: Findings suggest that contextual factors—namely, the environments in which hospice clinicians practice—may shape attitudes toward MAID. Unanticipated results indicating that hospice professionals’ adherence to hospice values was not significantly associated with attitudes toward MAID underscore the need for further research on these complex associations, given previous theoretical and empirical support.https://doi.org/10.1177/26323524241302097 |
| spellingShingle | Todd D. Becker John G. Cagle Cindy L. Cain Joan K. Davitt Nancy Kusmaul Paul Sacco Contextualizing attitudes toward medical aid in dying in a national sample of interdisciplinary US hospice clinicians: hospice philosophy of care, patient-centered care, and professional exposure Palliative Care and Social Practice |
| title | Contextualizing attitudes toward medical aid in dying in a national sample of interdisciplinary US hospice clinicians: hospice philosophy of care, patient-centered care, and professional exposure |
| title_full | Contextualizing attitudes toward medical aid in dying in a national sample of interdisciplinary US hospice clinicians: hospice philosophy of care, patient-centered care, and professional exposure |
| title_fullStr | Contextualizing attitudes toward medical aid in dying in a national sample of interdisciplinary US hospice clinicians: hospice philosophy of care, patient-centered care, and professional exposure |
| title_full_unstemmed | Contextualizing attitudes toward medical aid in dying in a national sample of interdisciplinary US hospice clinicians: hospice philosophy of care, patient-centered care, and professional exposure |
| title_short | Contextualizing attitudes toward medical aid in dying in a national sample of interdisciplinary US hospice clinicians: hospice philosophy of care, patient-centered care, and professional exposure |
| title_sort | contextualizing attitudes toward medical aid in dying in a national sample of interdisciplinary us hospice clinicians hospice philosophy of care patient centered care and professional exposure |
| url | https://doi.org/10.1177/26323524241302097 |
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