Grieving Assisted Dying: A Synthesised Grief Framework.

The recent legalization of assisted dying (AD) in New Zealand has reshaped experiences of dying and grief, yet AD-related grief remains under-theorised. Guided by the questions of whether particular forms of grief are more prominent at different stages of the AD process, and how these manifestations can inform a grief framework tailored to AD, this qualitative study explores and explains how grief theories apply to AD. Using appreciative inquiry, we interviewed 46 individuals eligible or ineligible for AD and family members. Inductive-deductive thematic analysis identified a distinct AD grief trajectory shaped by anticipatory and preparatory processes. Advocacy work and legacy work emerged as central practices supporting readiness, meaning-making, and continuing bonds, while stigma at times complicated coping and social expression of grief. The resulting framework also explains how loss- and restoration-oriented processes unfold within the intentional and socially embedded context of AD, offering guidance for clinicians, researchers, and policymakers.