A study published in Frontiers in Psychology for Clinical Settings shows that while current Swiss law does not necessarily increase the desire for assisted suicide, patients wish to discuss the option with their physician. Ralf Stutzki, researcher at the University of Basel Institut für Bio- und Medizininethik, interviewed 33 Swiss patients with Amyotrophic Lateral Sclerosis (ALS) to assess their attitudes towards assisted suicide. 94% (31) of the patients expressed no immediate wish for assisted suicide at the time of the interview, yet over half of the patients would like the option of discussing suicide by means of a prescribed drug with their doctor.
"This research makes it clear that doctors throughout Switzerland should be prepared to discuss end-of-life options with these kinds of patients," says Stutzki.
Liberal laws do not increase desire for death
According to this study, even though assisted suicide is permissible by Swiss law and tolerated by society, it does not appear as though the legal option increases the patients' desire for immediate death after having been diagnosed with the fatal disease.
"Other factors such as family life, quality of care and overall quality of life play a bigger role in determining the desire for assisted suicide than the mere existence of the permissive law," explains Stutzki. "But the possibility to eventually discuss the option with their doctor at a later stage is a comfort for the patient."
Suicide and ALS
ALS, known as Lou Gehrig's disease in North America, is the most common of neurodegenerative diseases. Its debilitating effects radically decrease the quality of life of its sufferers and ultimately lead to death. A 2004 study by the City of Zurich states that out of 421 cases of assisted suicide with Dignitas or Exit, 24% had neurological disorders, including ALS. In the Netherlands, 16.8% of ALS patients opted for physician-assisted suicide between 2000-2005.
Out of the 33 patients interviewed, 39% (13) said that they had already considered the possibility of suicide. While 94% of the interviewees did not express a desire for assisted suicide at the time of the interview, 54% of the patients could imagine asking a physician to prescribe a fatal drug that they could take themselves in the future. And 57% said that they could imagine a physician administering the drug—which is currently an illegal practice in Switzerland.
"The fact that over half of the patients I interviewed could imagine asking their physician to administer the drug, an illegal practice in Switzerland, reveals an attitude which exceeds the options provided by current law," says Stutzki. "The report highlights the need for a larger-scoped study to help guide the legal and ethical discussion."
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Stutzki, R. et al. "Attitudes towards assisted suicide and life-prolonging measures in Swiss ALS patients and their caregivers." Frontiers in Psychology for Clinical Settings, doi: 10.3389/fpsyg.2012.00443