• Andrea N Frolic, Marilyn Swinton, Leslie Murray, and Allyson Oliphant.
• Program for Ethics and Care Ecologies (PEaCE) and MAiD, Hamilton Health Sciences, Hamilton, Ontario, Canada frolic@hhsc.ca.
• BMJ Support Palliat Care. 2020 Dec 18.

BackgroundIndividuals who accompany a loved one through medical assistance in dying (MAiD) have to live with the experience and the psychological, moral and social consequences of their involvement in the process long after the death occurs.AimTo explore the legacy of a MAiD death for individuals who accompanied a loved one through the process.DesignUsing a qualitative descriptive approach we conducted semi-structured interviews to collect data from family members who had accompanied a loved one through MAiD. Data were analysed using conventional content analysis.Setting/Participants16 family members of 14 patients who received MAiD at a Canadian hospital with an interdisciplinary MAiD programme.ResultsThe main theme in the analysis is the opposing tensions experienced by individuals who accompany a loved one through a MAiD death, which we conceptualise as a double-edge experience. This double-edge experience is illustrated through four thematic opposing tensions: (1) support for patient autonomy and ambivalence about the MAiD choice, (2) gratitude for suffering relieved for loved one and grief for lost time with loved one, (3) time as a gift and time as a burden and (4) positive legacy and challenging bereavement experience.ConclusionThe nature of the MAiD experience for involved families is rooted in complexity, ambiguity and ambivalence and thus resists easy categorisation. Families would benefit from structured psychosocial and spiritual supports that acknowledge this complexity, along with MAiD-specific bereavement support following the death.© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

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