Swiss Families' Experiences of Interactions with Providers during Assisted Suicide: A Secondary Data Analysis of an Interview Study

Abstract

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.

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

“…The first of the “double-edge experience,” and fourth overall theme identified was poor social integration and stigma following Medical Aid in Dying. These were mentioned in two studies, 29 , 31 which reported that participants stated they perceived being stigmatized by others and felt they were not supported as much as individuals whose family/friend died a “natural death.” The fifth risk factor theme identified was less overall time with the person who engaged in Medical Aid in Dying. Participants reported that, following the loss, they felt they lost time with the person and “time is a gift” 30 that was taken from them.…”

Contemplating the Impacts of Canadian Healthcare Institutions That Refuse to Provide Medical Assistance in Dying: A Framework-Based Discussion of Potential Health Access Implications

“…19 In this regard, all CIHI dimensions availability of information , travel , referral route , and timeliness must function together for implementing a patient-centred MAiD system across the country. As we note earlier, MAiD-seeking individuals are often engaged in and informed by patient rights movements, 38 and associate assisted death with personal empowerment, dignity, and autonomy in care. 33,39 However, abstaining institutions—and their positions framing palliative support as incompatible with assisted dying—could result in patients deeming such care inappropriate for their needs.…”

Double-edged MAiD death family legacy: a qualitative descriptive study

“…There is an emerging need identified in other Canadian literature15 as well as through our exploratory study, for structured psychosocial and spiritual support for families both during and after the MAiD process. Importantly, there is an opportunity for including a palliative approach to care for family members during the MAiD process because their experience touches on many of the core dimensions of palliative care including: whole-person care, quality-of-life focus and mortality acknowledgement 18. The aims of these psychosocial and spiritual resources should be to: (1) normalise the complexity of the experience and the ambivalence family may be feeling, (2) offer ways for families to engage in meaningful activities to enrich the MAiD reflection period beyond merely ‘waiting it out’ (ie, such as legacy work, oral history, dignity therapy, etc) and (3) enhance the whole-person aspects of the MAiD process.…”