Understanding of Voluntary Assisted Dying among family members of older adults with mental illnesses: A phenomenological study

Background: Voluntary Assisted Dying (VAD) for older adults with a diagnosis of mental illnesses is surrounded by polarising views regarding its ethical and moral dilemmas. One of the requirements for VAD in Queensland is the presence of intact decision-making capacity, which might not be present in the case of individuals with mental illnesses. Family members play a crucial role in such cases, mostly in decision-making regarding such populations. The interdependence of patient and physician in this process is well recognised, but family members are not prioritised in the guiding documents of VAD. Thus, open questioning about the intention and blaming the family members is prevalent; it makes the journey of VAD traumatic and filled with dilemmas and presumptions. Mental illnesses are not usually acknowledged openly due to stereotypes and stigma. These all might influence the decision of individuals who want to opt for VAD, as choosing VAD is found to cause strain in personal relationships among family members. Past literature has focused on the views of physicians and staff participating in VAD. It is of utmost importance to explore the understanding of VAD among family members, too.