Content of health status reports of people seeking assisted suicide: a qualitative analysis.
Two right-to-die organisations offer assisted suicide in Switzerland. The specific legal situation allows assistance to Swiss and foreign citizens. Both organisations require a report of the person's health status before considering assistance. This qualitative study explored these reports filed to legal authorities after the deaths of individuals in the area of Zurich. Health status reports in the legal medical dossiers of the deceased were analysed using content analysis and Grounded Theory. From 421 cases of assisted suicide (2001-2004), 350 reports on health status were filed. Many cases contained diagnosis lists only. Other reports had more elaborate reports revealing that some physicians were aware about the patient's death wish and the intention to solicit assisted suicide. Physicians' attitudes ranged from neutral to rather depreciative. Few physicians openly referred the patient to the organisations and supported the patient's request by highlighting a history of suffering as well as reporting understanding and agreement with the patient's wish to hasten death. In the health status reports five categories could be identified. Some files revealed that physicians were aware of the death wish. The knowledge and recognition of the patient's death wish varied from no apparent awareness to strongly supportive. This variety might be due to difficulties to discuss the death wish with patients, but might also reflect the challenge to avoid legal prosecution in the country of origin. To require comparable health status reports as requirements for the right-to-die organisations might be difficult to pursue.
Institute of Nursing, School of Health Professions, Zurich University of Applied Science, Winterthur, Switzerland. imhl@zhaw.ch
Lorenz
L
Imhof
Georg
G
Bosshard
Susanne
S
Fischer
Romy
R
Mahrer-Imhof
D003142:Communication; D006304:Health Status; D006801:Humans; D036301:Qualitative Research; D017236:Suicide, Assisted; D013557:Switzerland
Nurse Res. 2006 Jul 1;13(4):84
27702218
Nurs Times. 2009 Aug 4-17;105(30):31-3
19736798
Psychooncology. 2010 Apr;19(4):339-52
19771571
BMJ. 2008 Dec 02;337:a2814
19050028
J Law Med Ethics. 2009 Summer;37(2):318-30
19493076
Swiss Med Wkly. 2002 Oct 12;132(37-38):527-34
12508137
Br J Nurs. 2009 Dec 10-2010 Jan 13;18(22):1396-7
20081697
Int J Legal Med. 2003 Apr;117(2):106-8
12690508
Swiss Med Wkly. 2009 Jun 13;139(23-24):333-8
19529991
J Rural Health. 2003 Fall;19(4):461-9
14526504
Swiss Med Wkly. 2003 May 31;133(21-22):310-7
12861469
Med Health Care Philos. 2010 Feb;13(1):1-2
19830592
Lancet Oncol. 2006 Jul;7(7):529-31
16814204
J Med Ethics. 2008 Nov;34(11):810-4
18974416
N Engl J Med. 2009 Sep 10;361(11):1119-21
19741238
Lancet. 2003 Aug 2;362(9381):395-9
12907015
Palliat Med. 2006 Oct;20(7):653-9
17060263
N Engl J Med. 2000 Feb 24;342(8):557-63
10684915