Supporting a Different Type of Death: Experiences of Family Members of Recipients of Medical Assistance in Dying

AIM: To explore the experiences of family members when a relative or close person receives medical assistance in dying. DESIGN: Guided by Interpretive Description methodology, this qualitative study was conducted across two settings. Participants included bereaved family members of individuals who received clinician-assisted medical assistance in dying when natural death was reasonably foreseeable and key informants connected to medical assistance in dying, palliative care and end-of-life organizations. METHODS: Data were collected between June 2020 and February 2021 through demographic surveys, in-depth interviews, documents and artifacts, field notes and analytic memos. Data collection and analysis occurred concurrently and iteratively, supporting the development of practice-relevant interpretations of family members' experiences. RESULTS: Forty-six participants, including 31 bereaved family members and 15 key informants, participated. Three interpretive themes characterized family members' experiences: (a) 'They want medical assistance in dying, now what?', (b) 'Prepared but maybe not ready' and (c) 'An evolving understanding about this type of death'. Family members described navigating healthcare processes, assuming practical and emotional responsibilities, and negotiating their own beliefs while supporting the individual's decision. They also described meaningful opportunities for connection and farewell alongside uncertainty, moral strain and emotional upheaval. Supporting a relative's decision to pursue medical assistance in dying did not necessarily correspond to emotional preparedness for the death or subsequent bereavement. CONCLUSION: Medical assistance in dying is experienced not only as an individual decision but also as a relational process with emotional, practical and moral implications for family members. A family-in-focus approach may complement person-centred care by increasing the visibility of family members throughout the MAiD trajectory. Proactive communication, recognition of emotional complexity, and access to psychosocial and bereavement support may better address the needs of family members while maintaining the autonomy of the individual accessing an assisted death. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.