Kowalinski Eva, Ziltener Tiziana, Staub Sarah, Moeller Julian, Trachsel Manuel, Schneeberger Andres R, Franke Irina, Lang Undine E, Huber Christian G
Department of Adult Psychiatry, University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland.
Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland.
Front Psychiatry. 2022 Oct 28;13:987791. doi: 10.3389/fpsyt.2022.987791. eCollection 2022.
Article 115 of the Swiss Penal Code (StGB) permits physician-assisted dying (PAD), provided it is not performed for "selfish reasons," and thus, occupies a special role in international comparison. However, the Swiss federal law does not regulate who exactly is entitled to access PAD, and there is no universal agreement in the concerned professional societies. Additional uncertainty arises when assessing the wish for PAD of a mentally ill person compared to a somatically ill person.
This study aims to contribute to the discussion of PAD among the mentally ill and to provide insight into the current situation in Switzerland.
This is a monocentric prospective observational survey-based study. We will conduct an exploratory online/telephone survey about PAD in somatic vs. mental illness in Switzerland. The survey sample will comprise 10,000 Swiss residents of the general population from all three language regions (German, Italian, and French) as well as 10,000 medical professionals working in the seven states ("cantons") of Basel-Stadt, Basel-Landschaft, Aargau, Lucerne, Graubünden, Ticino, and Vaud. Opinions on PAD in mentally and somatically ill patients will be assessed using 48 different case vignettes. Each participant will be randomly assigned a somatic terminal, a somatic non-terminal, and a mental non-terminal case vignette. Furthermore, the attitude toward the ethical guidelines of the Swiss Medical Association of 2004, 2018, and 2022, as well as the stigmatization of mentally ill people will be assessed.
Physician-assisted dying in mentally ill persons is a highly relevant yet controversial topic. On the one hand, mentally ill persons must not be discriminated against in their desire for PAD compared to somatically ill persons while at the same time, their vulnerability must be considered. On the other hand, treating physicians must be protected in their ethical integrity and need security when judging PAD requests. Despite its relevance, data on PAD in the mentally ill is sparse. To regulate PAD for the mentally ill, it is therefore important for Switzerland-but also internationally-to gain more insight into the ongoing debate.
ClinicalTrials.gov, identifier: NCT05492461.
《瑞士刑法典》（StGB）第115条允许医生协助的死亡（PAD），前提是其实施并非出于“自私的原因”，因此，在国际比较中占据特殊地位。然而，瑞士联邦法律并未规定究竟谁有权获得PAD，相关专业协会也未达成普遍共识。与躯体疾病患者相比，评估精神疾病患者对PAD的意愿时会产生更多不确定性。
本研究旨在推动关于精神疾病患者中PAD的讨论，并深入了解瑞士的现状。
这是一项基于单中心前瞻性观察调查的研究。我们将针对瑞士躯体疾病与精神疾病中的PAD开展一项探索性在线/电话调查。调查样本将包括来自所有三个语言区（德语、意大利语和法语）的10000名瑞士普通居民，以及在巴塞尔市、巴塞尔乡村、阿尔高、卢塞恩、格劳宾登、提契诺和沃州这七个州（“行政区”）工作的10000名医学专业人员。将使用48个不同的病例 vignette 评估对精神疾病和躯体疾病患者中PAD的看法。每位参与者将被随机分配一个躯体终末期、一个躯体非终末期和一个精神非终末期病例 vignette。此外，还将评估对瑞士医学协会2004年、2018年和2022年道德准则的态度，以及对精神疾病患者的污名化情况。
精神疾病患者的医生协助死亡是一个高度相关但有争议的话题。一方面，与躯体疾病患者相比，精神疾病患者在对PAD的渴望上不应受到歧视，同时，必须考虑到他们的脆弱性。另一方面，治疗医生在判断PAD请求时，其道德操守必须得到保护且需要安全感。尽管其相关性很高，但关于精神疾病患者中PAD的数据却很稀少。因此，对于瑞士乃至国际而言，为规范精神疾病患者的PAD，更深入了解正在进行的辩论很重要。
ClinicalTrials.gov，标识符：NCT05492461。
