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Updated: Jan 5, 2026

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Grief After Euthanasia and Physician-Assisted Suicide.

Karl Andriessen¹, Karolina Krysinska^1,2, Dolores Angela Castelli Dransart³

¹Centre for Mental Health, School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.

|October 29, 2019

Summary

Bereavement after euthanasia and physician-assisted suicide (PAS) does not appear to increase risks for disordered grief or mental health issues. Factors like social support and secrecy can impact grief, while involvement in decision-making may help.

Keywords:

assisted suicide bereavement euthanasia grief medical assistance in dying mental health systematic review

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Area of Science:

Medical Ethics
Psychology
Sociology

Background:

Euthanasia and physician-assisted suicide (PAS) are regulated in several countries.
Existing research primarily focuses on patients, families, and professionals, with limited data on bereaved individuals.
The impact of euthanasia and PAS on the grief and mental health of survivors remains under-explored.

Purpose of the Study:

To systematically review existing literature on grief and mental health outcomes in individuals bereaved by euthanasia or PAS.
To assess the quality of research examining the psychological impact of end-of-life choices on survivors.
To identify factors that may influence the grief process following euthanasia or PAS.

Main Methods:

Systematic review conducted according to PRISMA guidelines.
Searches performed across major databases: Cinahl, Embase, PsycINFO, Pubmed, and Scopus.
Analysis of 10 articles, representing eight distinct studies, with an assessment of their methodological quality.

Main Results:

Individuals bereaved by euthanasia/PAS generally reported similar or lower levels of disordered grief, mental health issues, and posttraumatic stress compared to those bereaved by natural death.
Factors such as lack of social support and secrecy were identified as potential exacerbating elements in the grief process.
Involvement in the decision-making process and the perception of honoring the deceased's wishes appeared to facilitate grief adjustment.

Conclusions:

Current evidence suggests no increased risk of adverse grief or mental health outcomes for individuals bereaved by euthanasia or PAS.
The quality of existing research is fair, but limitations include reliance on self-reports, retrospective designs, and limited geographical scope.
High-quality studies are needed to further investigate factors influencing grief in the context of legalized assisted dying.