title: Reasons why people in Switzerland seek assisted suicide: the view of patients and physicians.
abstract: 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.
authors.affiliation: Evaluation Office, University of Zurich, Switzerland. susanne.fischer3@bluewin.ch
authors.forename: Susanne
authors.initials: S
authors.lastname: Fischer
authors.forename: Carola A
authors.initials: CA
authors.lastname: Huber
authors.forename: Matthias
authors.initials: M
authors.lastname: Furter
authors.forename: Lorenz
authors.initials: L
authors.lastname: Imhof
authors.forename: Romy
authors.initials: R
authors.lastname: Mahrer Imhof
authors.forename: Christian
authors.initials: C
authors.lastname: Schwarzenegger
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Ziegler
authors.forename: Georg
authors.initials: G
authors.lastname: Bosshard
mesh_terms: 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