Medical assistance in dying on psychiatric versus somatic grounds: survey on the experiences of relatives

Background Relatives are often intimately involved in medical assistance in dying (MAID) on both psychiatric and somatic grounds. Greater insight into the extent to which certain experiences occur in practice will help physicians provide support. Aims To investigate how relatives of patients who received psychiatric versus somatic MAID scored on measures of opinions and emotions regarding the MAID trajectory; involvement in the trajectory; and judgement of the due care criteria. Method We included 616 Dutch relatives (18 years and over) of patients who received psychiatric or somatic MAID, recruited via an online cross-sectional survey conducted in the Netherlands between April 2023 and February 2025. Survey distribution occurred via social media, pamphlets, a patient federation and newspapers. In total, 110 participants had experienced psychiatric MAID and 506 somatic MAID. Outcomes included the following: opinions about the duration of the MAID trajectory; emotions due to MAID (five-point Likert scale); involvement in the MAID trajectory (five-point Likert scale); judgement of the due care criteria (five-point Likert scale); and total Empathy Questionnaire score (a validated scale). Results Following psychiatric MAID, gratitude, resignation, relief and sadness were most strongly felt (mean 3.5–4.2 on a scale from 1 to 5). More than 25% felt insufficiently involved in the MAID trajectory, and more than 80% positively judged the due care criteria, with no differences between psychiatric and somatic MAID. Respondents who experienced psychiatric MAID felt greater powerlessness ( p = 0.026, 95% CI [−1.082, −0.069]) and guilt ( p = 0.004, 95% CI [−0.833, −0.166]), and more often found the MAID trajectory too long (68.3 v . 21%, p < 0.001, U = 37 118, z = 9.19). Conclusions Relatives of people who received psychiatric MAID generally reported positive experiences that did not differ from those with somatic MAID. In regard to psychiatric MAID, relatives experienced greater powerlessness and guilt, emphasising the importance of relative involvement and support. Future research should investigate how this involvement can be optimised.