Assisted suicide in an acute care hospital: 18 months' experience.
OBJECTIVE
In 2006 the University Hospital of Lausanne (CHUV) introduced an institutional directive specifying the conditions for assisted suicide, in accordance with professional guidelines and the recommendation of the Swiss National Advisory Commission on Biomedical Ethics that every acute care hospital take up a position on this subject.


METHODS
18-months follow-up analysis of patient requests and application of the directive by hospital staff.


RESULTS
Of the 54,000 patients hospitalised between January 1, 2006, and June 30, 2007, six requests were recorded, all within the first 7 months after introduction of the directive and in the context of severe and life-threatening diseases. However, only one of the six patients, living in a nursing home belonging to the hospital, died by assisted suicide. Two patients died from their diseases, one during the assessment procedure and the other shortly after. One patient withdrew his request after pain control, returned home and died several weeks later. Another patient, although she was severely ill and died several months later, was denied the procedure because her condition was improving. Only one patient was declared incompetent and his request refused. The time distribution of requests seems to be associated with initial media coverage of the assisted-suicide directive's introduction. Only minor amendments to the directive were needed.


CONCLUSIONS
The recommendations of the Swiss National Advisory Commission on Biomedical Ethics are applicable in an acute care hospital.
Wasserfallen
Jean-Blaise
JB
Intensive Care Service, University Hospital Centre, University of Lausanne, Lausanne, Switzerland. jbw@chuv.ch
Chioléro
René
R
Stiefel
Friedrich
F
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006739:Hospital Administration; D006801:Humans; D008297:Male; D008875:Middle Aged; D017236:Suicide, Assisted