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  • ‘How is it possible that at times we can be physicians and at times assistants in suicide?’ Attitudes and experiences of palliative care physicians in respect of the current legal situation of suicide assistance in Switzerland

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Clinical ethics
‘How is it possible that at times we can be physicians and at times assistants in suicide?’ Attitudes and experiences of palliative care physicians in respect of the current legal situation of suicide assistance in Switzerland
  1. Martyna Tomczyk1,
  2. Roberto Andorno2,
  3. Ralf J Jox1,3
  1. 1 Institute of Humanities in Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
  2. 2 Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
  3. 3 Palliative and Supportive Care Service, Chair in Geriatric Palliative Care, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
  1. Correspondence to Dr Martyna Tomczyk, Institute of Humanities in Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Martyna.Tomczyk{at}chuv.ch

Abstract

Introduction Switzerland lacks specific legal regulation of assistance in suicide. The practice has, however, developed since the 1980s as a consequence of a gap in the Swiss Criminal Code and is performed by private right-to-die organisations. Traditionally, assistance in suicide is considered contrary to the philosophy of palliative care. Nonetheless, Swiss palliative care physicians regularly receive patient requests for suicide assistance. Their attitudes towards the legal regulations of this practice and their experience in this context remain unclear.

Objectives Our study aimed to explore and describe the attitudes and experiences of Swiss palliative care physicians concerning the legal situation of suicide assistance.

Methods In 2019, we performed an exploratory interview study with 12 Swiss palliative care physicians on palliative sedation as an alternative to assisted suicide. In this paper, we present the results that emerged from a thematic subanalysis of the data.

Results Participants stated that assistance in suicide and palliative care are based on opposing philosophies, but they admitted a shift in paradigm over the last years in the sense that one practice does not necessarily exclude the other. They reported various roles in suicide assistance and considered that the current activities of Swiss right-to-die organisations were problematic and needed to be regulated by law.

Discussion and conclusion These results could enrich national and international reflection on suicide assistance in the context of palliative care by reducing confusion between the two practices and strengthening the confidence of patients and their relatives.

  • Palliative Care

Data availability statement

No data are available. All data are not available because of information that potentially permits the participants to be identified, particularly as the names of the institutions that participated in this study and the characteristics of the participants are explicitly indicated in our previous paper.

https://doi.org/10.1136/jme-2022-108546

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    Data availability statement

    No data are available. All data are not available because of information that potentially permits the participants to be identified, particularly as the names of the institutions that participated in this study and the characteristics of the participants are explicitly indicated in our previous paper.

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    Footnotes

    • Contributors MT contributed to study conception and design, data collection, analysis and interpretation. She also translated the results, including the quotations, from French into English. RA and RJJ contributed to the interpretation and discussion of the data and the final results. All authors prepared the final version of the results. MT wrote the manuscript with input from both the other coauthors. MT is the guarantor. All the authors read and approved the final version of the manuscript.

    • Funding This study was not funded by any grant. MT received a Swiss Government Excellence Scholarship (CH). The research was independent of any involvement from this structure.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.