An examination and proposed theoretical model of risk and protective factors for bereavement outcomes for family members of individuals who engaged in medical aid in dying: A systematic review

Abstract

Background: Medical Aid in Dying is an end-of-life option that allows a physician to provide a patient with a prescription to end their life. Though Medical Aid in Dying intends to reduce suffering for a patient, opponents argue Medical Aid in Dying may increase suffering for the family members during bereavement. To better understand the bereavement outcomes for family members/friends following Medical Aid in Dying, an exhaustive review of the risk and protective factors for bereavement outcomes is warranted. Aim: This systemic review aimed to identify studies that examined bereavement outcomes of family members of individuals who engage in Medial Aid in Dying, identify risk and protective factors for bereavement outcomes, and propose a theoretical model to enhance conceptual clarity. Design: A mixed-method systematic review. Data sources: Ten databases were searched on June 16, 2021 and later conducted two updates (latest April 25, 2022). Results: Thirteen articles met inclusion criteria. Risk and protective factors were identified pre-Medical Aid in Dying and risk factors post-Medical Aid in Dying. Few studies compared bereavement outcomes for family members of individuals utilizing Medical Aid in Dying to family members who lost someone to natural loss. Conclusions: This study provides equivocal results about the effects of Medical Aid in Dying on family members following the loss. The theoretical model outlines potential risk and protective factors. This model provides a greater understanding of possible universal risk and protective factors for family members of individuals who engaged in Medical Aid in Dying.

Views, Attitudes and Challenges When Supporting a Family Member in Their Decision to Travel to Switzerland to Receive Aid-In-Dying

“…By providing support for the individual seeking suicide tourism, the participants in this study were also able to exercise control, allowing time for others to say goodbye, for example, and reducing their suffering and burden. In their systematic review of the literature, Singer et al [ 51 ] discuss both protective and risk factors regarding the bereavement outcomes of family members, following the medical aid-in-dying of a loved one. Indeed, in the current study, the participants expressed their need for support for themselves throughout the process, as they often felt alone, overwhelmed, or conflicted.…”

“Walk me through the final day”: A thematic analysis study on the family caregiver experience of the Medical Assistance in Dying procedure day

“…Current research, predominantly from European (particularly Swiss) and North American (specifically, Oregonian and Canadian) sources suggests that family members are typically involved in all stages of the assisted dying process [7][8][9][10][11][12] and that their involvement with the assisted dying process may impact their emotional well-being and shape how their grief unfolds. [7][8][9][10][13][14][15][16] .…”