Exit Music: The Experience of Music Therapy within Medical Assistance in Dying

Since the 2015 legalization of medical assistance in dying (MAiD), healthcare professionals across the interdisciplinary spectrum have been exploring their roles within this practice, and a number of professions have created guidelines and policies to define their role(s). Many Canadian music therapists also found themselves implicated in care for those requesting MAiD. No prior research has been done to gain insight into the role of music therapy within the context of MAiD. This qualitative hermeneutic phenomenological study, the first of its kind, examines the experience of music therapy within medically assisted dying from three perspectives: the patient, their primary caregiver, and the music therapist/researcher. Ten cases that vary in duration of involvement of the music therapist, demographic, characteristics, and nature of the music therapy are presented through a hermeneutic phenomenological methodology lens. A total of 24 music therapy sessions and seven caregiver interviews were transcribed and analyzed. A total 28 researcher reflections were analyzed. The analysis of data revealed thematic trends of life reflection activated by the musical interaction (wherein the music functioned as a narrator and a trigger), control (over musical and ritualistic choices), communication and connectedness (with the self and others through music), and aesthetic pleasure (as a catalyst for therapeutic outcomes such as pain and symptom management). Caregiver participant results revealed trends of immediacy of access to emotion through music, reflection (on personal narratives within music), witnessing (of patients’ emotional and narrative expressions), and unexpected opportunities (for life review through music). Researcher reflection data analyses revealed thematic trends of trusting (in the midst of uncertainty), witnessing (of the unfolding of narratives through music), therapeutic relationship creation (with a sense of immediacy), and support for patients and caregivers in their navigation of their MAiD processes. These results may have implications as to how music therapy is offered, standardized, and implemented in settings where MAiD is provided, as the overarching thematic findings show therapeutically beneficial outcomes in terms of quality of life, life review, and symptom management. Further research is merited to continue to explore the role of music therapy in the context of assisted dying.Ph.D