In 2019, Special Interest Groups (SIGs) were selected by an IAMM review committee for inclusion at the conference. Each leader was charged with assembling topic experts from different disciplines and continents. These groups met virtually throughout the year to develop outcomes that included research proposals, educational programs, white papers, and clinical practice guidelines.

On June 24th, the Special Interest Group (SIG) on “Music Therapy and Medical Assistance in Dying” led a webinar to report on their work. 

Music Therapy and Medical Assistance in Dying

In this post we report on this SIG, which explored the clinical role of music therapy within the context of medical assistance in dying. Panelists discussed the revision process of clinical guidelines for Canada that were originally created in 2017, and have since been revisited and revised based on evidence-based methodology.

The panel consisted of a cohort of diverse professionals with varying expertise in music therapy and/or assisted dying. They explored ethical, educational, and practical implications of these guidelines.

SIG Members

This SIG was led by SarahRose Black, PhD, RP, MTA. Dr. SarahRose Black is an accredited music therapist and registered psychotherapist specializing in palliative care and psychosocial oncology at both the Princess Margaret Cancer Centre and Kensington Hospice in Toronto (Canada). She is a pianist, vocalist, violinist and music health educator, and has performed, taught and presented on her clinical work and research across Canada. 

SarahRose holds a Master of Arts in Music Education and a Master of Music Therapy, and recently completed her doctorate at the University of Toronto, where she conducted the first study on music therapy in the context of medical assistance in dying (MAiD). Her research and interest in this topic arose from her own experience of patients requesting her assistance during MAiD processes. With other professionals, Dr. Black facilitated the creation of the first practice guidelines in 2017. 

This SIG also includes the following individuals:

• Taylor Kurta, BMT, MA, MTA
• Amy Clements-Cortes, PhD, RP, MTA, MT-BC
• Joanne Loewy, DA, LCAT, MT-BC
• Elizabeth Mitchell, PhD, RP, MTA
• Jessica Lam, RN, BScN, CON
• Angela Wibben, MM, MT-BC
• Lee Bartel, PhD
• Melissa Jessop, MMT, RP, MTA
• Madeline Li, MD PhD FRCP
• Adrienne Pringle, MMT, RP, MTA
• Kiki Chang, MA, M.Ed., RP, MTA
• Karie Rippin Bilger, BMT, MSW, RP, MTA
• Sarah Pearson, MMT, RP, MTA

The first practice guidelines were written in 2017 and then revised in 2020. The revision took into consideration different perspectives, such as research, long-term care, ethics, education and curriculum, as well as end-of-life transitions. 

Definition of Medical Assistance in Dying

In accordance with federal legislation, Medical Assistance in Dying (MAiD) includes circumstances where a medical practitioner or nurse practitioner, at an individual’s request: (a) administers a substance that causes an individual’s death; or (b) prescribes a substance for an individual to self-administer to cause their own death (CPSO, 2016). 

Dr. Black reflected on the process of music therapy before, during, and after MAiD. These include familiar interventions, although there are differences in this context. 

Sections of the Guidelines

The guidelines also include the following sections: 

• Introduction
• Definition of Medical Assistance in Dying
• Ethical Stance
• Conscientious objection
• Potential role(s)
• Music therapy sessions
• Music therapy during MAiD Intervention
• MT for family support 
• MT for staff support
• Additional considerations
• Considerations for self-care
• References
• Appendices

Report from Taylor Kurta

Taylor Kurta, BMT, MA, MTA also reported on her insights regarding this work, particularly as she assisted Dr. Black’s doctoral research. She reported that there are challenging preconceptions, such as fear of not being approved for MAiD, fear of not being able to consent, and fear of disappointing family. 

Additionally, she pointed out that there is little to no research in MAiD in long-term care. Nevertheless, she argued that it is important to conduct research with MAiD in long-term care. 

By sharing two stories of working with patients in the context of MAiD, she was able to shed light on challenges of this work. She reported about a patient diagnosed with heart failure and how when she worked with her she didn’t know this patient was receiving MAiD. Her experiences then made her think about the potential effects of different ways to approach MAiD. 

And much more…

This post is just scratching the surface on the topic of MAiD and music therapy. We encourage you to check out the guidelines and/or access  www.music-medicine.net so you can watch the recording of the webinar. In that recording you can find out more about what the other panelists discussed. You can find the recording here.

A PDF of the latest revision of the Practice Guidelines for Music Therapy and Medical Assistance in Dying can be found here. 

A Quote to Finish

“For a few moments we could focus on the music and sort of forget the tragedy. So, not only was it a temporary distraction from the difficult and painful emotions, but it served to bring in a bit of levity and even some positive emotions that came with remembering the emotions that the music evoked during happier times.”