Schildmann J, Junghanss C, Oldenburg M, Schuler U, Trümper L, Wörmann B, Winkler E. Role and responsibility of oncologists in assisted suicide. Practice and views among members of the German Society of Haematology and Medical Oncology.
ESMO Open 2021;
6:100329. [PMID:
34896697 PMCID:
PMC8666647 DOI:
10.1016/j.esmoop.2021.100329]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/08/2021] [Accepted: 11/04/2021] [Indexed: 11/16/2022] Open
Abstract
Background
Physician-assisted suicide (PAS) is a controversial practice and regulatory frameworks differ regarding assigned physicians' roles. This study explores clinical experience and views of German oncologists concerning ethically and legally relevant aspects of PAS after change of the law.
Materials and methods
An online survey was conducted among members of the German Society of Haematology and Medical Oncology (DGHO) in March 2021. Descriptive analysis, bivariate and multivariable logistic regression of quantitative data on determinants related to (un)willingness to assist with suicide as well qualitative analysis of free-text comments were carried out.
Results
Seven hundred and forty-five of 3588 DGHO members responded (20.8%). Of these, 29.9% reported requests for a lethal drug and 3.0% (n = 22) reported to have assisted with suicide. Almost half of them (47.0%, n = 350) objected to providing PAS, whereas 45.9% indicated a willingness at least under certain conditions. Of those respondents who did not object to PAS, 25.4% would also consider assistance if those willing to die had a psychiatric disease and 10.2% if requestors had no disease at all. A majority viewed a role for physicians regarding different tasks associated with assisted suicide. Respondents with <10 years of professional experience, working in hospital with religious affiliation and with subspecialisation in palliative care were significantly less frequently willing to assist suicide.
Conclusions
Respondents are divided in their personal attitudes towards PAS but a majority supports involvement of physicians regarding different tasks related to assisted suicide. Data about the practice and envisaged professional role may inform development of an acceptable ethico-legal framework for a controversial practice.
In Germany, as in other countries, assisted suicide has become lawful more recently.
To be able to develop guidance on the highly controversial subject, empirical data on practice and related aspects are needed.
30% of responding oncologists report requests for lethal drugs by their patients and 3% have assisted with suicide.
Compared with 2015, significantly more oncologists report requests for lethal drugs and willingness to assist with suicide.
Palliative care qualification and less professional experience were negatively associated with willingness to assist suicide.
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