title: Families' experiences with patients who died after assisted suicide: a retrospective interview study in southern Switzerland.
abstract: BACKGROUND
  In Switzerland, if certain conditions are met, assisted suicide is not prosecuted. International debate suggests that requests for hasten death are often altered by the provision of palliative care. Aims of the study were to explore patients' reasons for choice of assisted suicide and family perceptions of the interactions with health care professionals.
  
  
  METHODS
  This is a qualitative study upon 11 relatives of 8 patients cared for by a palliative care team, deceased of assisted suicide.
  
  
  RESULTS
  Pain and symptom burden were not regarded by patients as key reasons to seek assisted suicide: existential distress and fear of loss of control were the determinants. Most patients had made pre-illness decisions to use assisted suicide. A general need for perceived control and fear of dependency were reported as a common characteristic of these patients. Patients held misunderstandings about the nature and purpose of palliative care, and the interviewed indicated that patients did not regard provision of palliative care services as influential in preventing their decision.
  
  
  CONCLUSIONS
  Assisted suicide was preferred despite provision of palliative care. Better understanding of the importance placed on perceived control and anticipated dependency is needed. Further research is needed to develop appropriate support for patients contemplating assisted suicide.
authors: Department of Palliative Care, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland. claudia.gamondi@eoc.ch
authors: C
authors: C
authors: Gamondi
authors: M
authors: M
authors: Pott
authors: S
authors: S
authors: Payne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death / Q000208:ethnology; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology* / Q000639:trends; D012189:Retrospective Studies; D017236:Suicide, Assisted / Q000208:ethnology / Q000523:psychology*; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000208:ethnology
keywords: assisted suicide; family; hasten death; interviews; palliative care; qualitative research