How voluntary assisted dying shapes bereavement and grief

While voluntary assisted dying (VAD) is an end-of-life option for eligible individuals in most Australian jurisdictions, there is little evidence regarding how VAD experiences impact carers’ bereavement and grief. Exploring these experiences particularly in the context of the chosen administration method (self-administration [SA] or practitioner-administration [PA]) has not been explored. Participants completed three online questionnaires and a semi-structured interview. Parametric and non-parametric tests were conducted to assess possible differences in grief outcomes across the two administration groups (SA and PA). Interviews were analysed using reflexive thematic analysis. Twenty-five individuals completed the questionnaires and interviews. On average, participants in the PA group scored higher on all grief outcomes, compared to the SA group; Brief Grief Questionnaire: PA mean 3.1 ± 2.6 vs. SA mean 2.7 ± 2.6; Impact of Event Scale-Revised: PA median = 19, IQR 8–34 vs. SA median = 9, IQR 2-20.5; Post Traumatic Stress Disorder Checklist: PA median = 8; IQR: 3–22 vs. SA median = 2, IQR 0–6. The higher effect sizes in the PA group for Impact of Event Scale-Revised and Post Traumatic Stress Disorder Checklists may suggest a potential clinical risk or significance. Five interview themes were generated (1) honouring the person’s wishes, (2) complexities of VAD access, (3) the VAD death experience, (4) support during and following bereavement, and (5) navigating life after VAD loss. Grief following a VAD death was highly individual. While the planned and intentional nature of VAD was often experienced as helpful, aspects of the process could also be confronting, regardless of administration method. Bereavement and grief may be shaped less by the administration method itself and more by the anticipatory and procedural aspects of the VAD process. These results underscore the importance of tailored, anticipatory bereavement support and contribute to the emerging, Australian evidence base on VAD-related grief.