{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:33:08Z","timestamp":1787923988753,"version":"build-2784847793"},"reference-count":25,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000147","name":"Canadian Cancer Society","doi-asserted-by":"publisher","award":["705663"],"award-info":[{"award-number":["705663"]}],"id":[{"id":"10.13039\/501100000147","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Assisted dying has become an increasingly available option. Limited literature explores how family members disclose a patient\u2019s choice of death by Medical Assistance in Dying (MAiD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To explore how family members handled the disclosure of the patients\u2019 choice to pursue MAiD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This qualitative study is part of a larger mixed-methods project examining patient and caregiver experiences with MAiD. Semi-structured interviews with family members of patients who had requested MAiD were conducted shortly after the patient\u2019s death and\/or approximately 6\u2009months post-death and analyzed using a modified grounded theory methodology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/participants:<\/jats:title>\n                    <jats:p>Participants were recruited at two tertiary hospitals in Toronto, Canada. Participants were included if they were identified by the patient requesting MAiD to be a family caregiver. A total of 55 interview transcripts from 43 participants were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Findings include a core category of \u2018dynamic disclosure\u2019, representing disclosure as an ongoing process informed by two subcategories that influence each other: \u2018Factors influencing disclosure\u2019 and \u2018Outcomes of disclosure\u2019. \u2018Factors influencing disclosure\u2019 include five subcategories: \u2018Honoring the patient\u2019s choice\u2019; \u2018Desire to advocate\u2019; \u2018Navigating the novelty and stigma\u2019; \u2018Reluctance to speak of death and dying\u2019; and \u2018Managing sensitive information\u2019. \u2018Outcomes of disclosure\u2019 include four subcategories: \u2018Validation and acceptance\u2019; \u2018Peer connection\u2019; \u2018Criticism, opposition, and silence\u2019; and \u2018Curiosity and knowledge seeking\u2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Disclosure of assisted dying is a complex, evolving process that is influenced by multiple factors. Understanding these factors and potential outcomes of disclosure can help inform healthcare professionals in supporting families throughout the assisted dying process and into bereavement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692163261476488","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T11:28:07Z","timestamp":1787570887000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dynamics of disclosure: A qualitative study of how family caregivers discuss deaths by medical assistance in dying"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3522-5333","authenticated-orcid":false,"given":"Yanin","family":"Kiatpanabhikul","sequence":"first","affiliation":[{"name":"Department of Psychiatry, King Chulalongkorn Memorial Hospital, Bangkok, Thailand"},{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Hales","sequence":"additional","affiliation":[{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6811-195X","authenticated-orcid":false,"given":"Eryn","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3977-7437","authenticated-orcid":false,"given":"Madeline","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6626-6974","authenticated-orcid":false,"given":"Gary","family":"Rodin","sequence":"additional","affiliation":[{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6703-975X","authenticated-orcid":false,"given":"Debbie","family":"Selby","sequence":"additional","affiliation":[{"name":"Division of Palliative Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elie","family":"Isenberg-Grzeda","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Bean","sequence":"additional","affiliation":[{"name":"Health Ethics Alliance &amp; Policy, Sunnybrook Health Sciences, Centre, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3624-5806","authenticated-orcid":false,"given":"Rinat","family":"Nissim","sequence":"additional","affiliation":[{"name":"Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"crossref","unstructured":"Deliens L. 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