Bereaved families express moral dilemmas, feelings of isolation and secrecy in the management of assisted suicide in Southern Switzerland. These features seem underestimated and not sufficiently recognised by the healthcare professionals. Management of assisted suicide requests should include consideration of family members' needs, in addition to those of the patient.

Families appeared to be involved in the preparation of assisted suicide along with patients, irrespective of their personal values regarding assisted dying. Support for family members is essential if they are involved in tasks preparatory to assisted suicide. Clinical guidelines and policies concerning assisted dying should acknowledge and address family needs.

Assisted suicide was preferred despite provision of palliative care. Better understanding of the importance placed on perceived control and anticipated dependency is needed. Further research is needed to develop appropriate support for patients contemplating assisted suicide.

Context: Families are known to be involved in assisted dying and their involvement can be influenced by many factors.Objectives: To explore how Swiss families interact with health care professionals and right to die associations regarding assisted suicide and their choices around disclosure.Methods: A secondary data analysis on a cross-sectional qualitative interview study conducted in the Italian and French speaking parts of Switzerland was conducted.Interviews with 28 bereaved family members were analyzed using framework analysis.Results: Two main themes were identified: 1. Interactions with physicians and right to die associations. 2.Choices about disclosing their experiences. In general, families believed that assisted suicide is a private matter, to be pursued mainly outside the medical field and involved physicians only when necessary. Families appeared to deliberately limit interaction with physicians and to be more comfortable interacting with right to die associations. Some participants presumed a clear choice between assisted suicide or palliative care. Disclosing to others the decision, and preparation of assisted suicide emerged to be an important emotional burden for families. Some family members preferred to restrict disclosure before and after assisted suicide, by sometimes not informing other family members until the final days. Conclusion:In Switzerland, there is limited interaction between families and health care professionals concerning assisted suicide decisions, while families reported more open interactions with right to die associations. It is recommended that the needs of families should be reflected in health policies, taking into consideration the different contexts where assisted dying is permitted.

L’assistance au suicide en Suisse est surtout accessible aux membres d’associations militant pour le droit de mourir dans la dignité. Elle s’est développée dans un contexte légal particulier. Les modalités de participation des proches à l’ensemble du processus sont peu connues. Cet article analyse ces accompagnements de fin de vie singuliers qui s’élaborent dans le cadre de trajectoires de maladies, articulées à une procédure d’assistance au suicide. Entre partage de souffrances, soins, négociations de délais et recherche de certificats, le quotidien des proches impliqués est occupé par de multiples tâches, dont la moindre n’est pas de choisir à qui annoncer la date et les conditions de la mort.