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Attitudes toward assisted suicide requests in the context of severe and persistent mental illness: A survey of psychiatrists in Switzerland

Published online by Cambridge University Press:  27 May 2019

Martina A. Hodel Open the ORCID record for Martina A. Hodel [Opens in a new window] ,
Paul Hoff ,
Scott A. Irwin ,
Nikola Biller-Andorno ,
Florian Riese  and
Manuel Trachsel
Martina A. Hodel*
Affiliation:
Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
Paul Hoff
Affiliation:
Psychiatric University Hospital Zurich, Zurich, Switzerland
Scott A. Irwin
Affiliation:
Cedars-Sinai Health System, Los Angeles, CA
Nikola Biller-Andorno
Affiliation:
Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
Florian Riese
Affiliation:
Psychiatric University Hospital Zurich, Zurich, Switzerland
Manuel Trachsel
Affiliation:
Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
*
Author for correspondence: Martina A. Hodel, Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006, Zurich, Switzerland. E-mail: [email protected]
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Abstract

Objective

Switzerland is among the few countries worldwide where a request for assisted suicide (AS) can be granted on the basis of a primary psychiatric diagnosis. Psychiatrists play an increasingly important role in this regard, especially when the request for AS arises in the context of suffering caused by severe and persistent mental illness (SPMI). The objective of the survey was to assess general attitudes among psychiatrists in Switzerland regarding AS requests from patients with SPMI.

Method

In a cross-sectional survey of 1,311 German-speaking psychiatrists in Switzerland, participants were asked about their attitude to AS for patients with SPMI, based on three case vignettes of patients diagnosed with anorexia nervosa, treatment-refractory depression, or severe persistent schizophrenia.

Result

From a final sample of 457 psychiatrists (a response rate of 34.9%) whose mean age was 57.8 years, 48.6% of respondents did not support access to AS for persons diagnosed with SPMI, 21.2% were neutral, and 29.3% indicated some degree of support for access. In relation to the case vignettes, a slightly higher percentage of respondents supported the patient's wish to seek AS: 35.4% for those diagnosed with anorexia nervosa, 32.1% for those diagnosed with depression, and 31.4% for those diagnosed with schizophrenia.

Significance of results

Although a majority of the responding psychiatrists did not support AS for SPMI patients, about one-third would have supported the wishes of patients in the case vignettes. In light of the increasing number of psychiatric patients seeking AS and the continuing liberalization of AS practices, it is important to understand and take account of psychiatrists’ perspectives.

Keywords

Assisted suicidemedical aid in dyingrational suicidesevere and persistent mental illnesstreatment resistance
Type
Original Article
Information
Palliative & Supportive Care , Volume 17 , Issue 6 , December 2019 , pp. 621 - 627
Copyright
Copyright © Cambridge University Press 2019 

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