Reasons why people in Switzerland seek assisted suicide: the view of patients and physicians.
BACKGROUND
Assisted suicide is permitted in Switzerland provided that assistance is not motivated by selfish reasons. Suicides are commonly performed with the assistance of right-to-die organisations and the use of a lethal dose of barbiturates prescribed by a participating physician. We examined the reasons physicians provided for writing the prescription and the reasons patients gave for requesting assistance in dying.


METHODS
We analysed all reported cases of assisted suicide that were facilitated by right-to-die organisations between 2001 and 2004 in the city of Zurich, and for which both the medical report and the optional letter written by the decedent providing information on their reasons for seeking assistance in suicide (N = 165).


RESULTS
The reasons most often reported by physicians (ph), as well as persons who sought help (p), were: pain (ph: 56% of all assisted suicides, p: 58%), need for long-term care (ph: 37%, p: 39%), neurological symptoms (ph: 35%, p: 32%), immobility (ph: 23%, p: 30%) and dyspnoea (ph: 23%, p: 23%). Control of circumstances over death (ph: 12%, p: 39%); loss of dignity (ph: 6%, p: 38%); weakness (ph: 13%, p: 26%); less able to engage in activities that make life enjoyable (ph: 6%, p: 18%); and insomnia and loss of concentration (ph: 4%, p: 13%) were significantly more often mentioned by decedents than by physicians.


CONCLUSIONS
Both prescribing physicians and;patients provided with assistance to die quite often mentioned pain and other concerns, many of which were objectively assessable and related to unbearable suffering or unreasonable disability. Concerns referable to autonomy and individual judgement were more often noted by people seeking help than by the prescribing physicians.
Fischer
Susanne
S
Evaluation Office, University of Zurich, Switzerland. susanne.fischer3@bluewin.ch
Huber
Carola A
CA
Furter
Matthias
M
Imhof
Lorenz
L
Mahrer Imhof
Romy
R
Schwarzenegger
Christian
C
Ziegler
Stephen J
SJ
Bosshard
Georg
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain; D010342:Patient Acceptance of Health Care; D010817:Physician-Patient Relations; D011788:Quality of Life; D012189:Retrospective Studies; D017236:Suicide, Assisted / Q000523:psychology*; D013557:Switzerland