What About the Family? A Content Analysis of International Legislative Frameworks and Guidelines on Assisted Dying

When a person chooses assisted dying, the impact on their family can be profound. Legislation and professional guidelines not only regulate and standardize practice, but also support the delivery of high-quality care. Within this framework, bereavement care plays a vital role by helping families prepare for the death and potentially reducing the risk of prolonged grief. This study explored how current legislation and clinical guidelines on assisted dying address the role and needs of family members, particularly regarding bereavement care. It examined the frequency of the term "family" and its synonyms, as well as the extent to which bereavement support services for relatives are described. A content analysis was conducted on legislative and guideline documents from countries where physician-administered assisted dying is legal. Documents were collected between August 2022 and June 2023, and both quantitative and qualitative analyses were used to assess references to families and descriptions of bereavement care. In total, 22 legislative frameworks and 38 clinical guidelines from nine countries were analyzed. References to family appeared far more often in guidelines (N = 1,213) than in legislation (N = 147). The frequency of these terms varied significantly, with guidelines ranging from two to 83 mentions, and legislation from zero to 18. Eight key themes related to bereavement care emerged, though specific guidance was often lacking. To improve quality care, there is a clear need to better integrate family support into assisted dying guidelines by establishing best practices for bereavement care. Future research should focus on family members' perspectives and needs.