Department of Breast Surgery, Brust-Zentrum Zürich, Zurich, Switzerland.
Faculty of Medicine, University of Basel, Basel, Switzerland.
Cancer Med. 2023 Aug;12(16):17296-17307. doi: 10.1002/cam4.6323. Epub 2023 Aug 9.
We tested the hypothesis of supporters of assisted dying that assisted suicide (AS) might be able to prevent cases of conventional suicide (CS).
By using data from the Federal Statistical Office, we analyzed the long-term development of 30,756 self-initiated deaths in Switzerland over a 20-year period (1999-2018; CS: n = 22,018, AS: n = 8738), focusing on people suffering from cancer who died from AS or CS.
While cancer was the most often listed principal disease for AS (n = 3580, 41.0% of AS cases), cancer was listed in only a small minority of CS cases (n = 832, 3.8% of CS cases). There was a significant increase in the absolute number of cancer-associated AS cases: comparing four 5-year periods, there was approximately a doubling of cases every 5 years (1999-2003: n = 228 vs.2004-2008: n = 474, +108% compared with the previous period; 2009-2013: n = 920, +94%; 2014-2018: n = 1958, +113%). The ratio of cancer-associated AS in relationship with all cancer-associated deaths increased over time to 2.3% in the last observation period (2014-2018). In parallel, the numbers of cancer-associated CS showed a downward trend only at the beginning of the observation period (1999-2003, n = 240 vs. 2004-2008, n = 199, -17%). Thereafter, the number of cases remained stable in the subsequent 5-year period (2009-2013, n = 187, -6%), and increased again toward the most recent period (2014-2018, n = 206, +10%).
The assumption that, with the increasingly accessible option of AS for patients with cancer, CS suicide will become "superfluous" cannot be confirmed. There are strong reasons indicating that situations and circumstances of cancer-associated CS are different from those for cancer-associated AS.
我们检验了支持辅助自杀的观点，即辅助自杀（AS）可能能够预防常规自杀（CS）的发生。
我们利用联邦统计局的数据，分析了瑞士 20 年间（1999-2018 年）30756 例自主死亡的长期发展情况，其中包括因 CS（n=22018）和 AS（n=8738）而死亡的患者，重点关注患有癌症且通过 AS 或 CS 死亡的患者。
尽管癌症是 AS 最常被列为主要疾病的疾病（n=3580，占 AS 病例的 41.0%），但在 CS 病例中仅很少一部分患者（n=832，占 CS 病例的 3.8%）被列为癌症。与癌症相关的 AS 病例数量呈显著增加趋势：在四个 5 年期间进行比较，每隔 5 年病例数量大约增加一倍（1999-2003 年：n=228 例，2004-2008 年：n=474 例，与前一时期相比增加了 108%；2009-2013 年：n=920 例，增加了 94%；2014-2018 年：n=1958 例，增加了 113%）。与所有与癌症相关的死亡病例相比，与癌症相关的 AS 比例随着时间的推移而增加，在最后一次观察期（2014-2018 年）达到 2.3%。与此同时，与癌症相关的 CS 数量仅在观察期开始时呈下降趋势（1999-2003 年，n=240 例，2004-2008 年，n=199 例，下降了 17%）。此后，在随后的 5 年期间，病例数量保持稳定（2009-2013 年，n=187 例，下降 6%），并在最近的时期再次增加（2014-2018 年，n=206 例，增加 10%）。
不能证实这样的假设，即随着癌症患者可获得的辅助自杀选择越来越多，CS 自杀将变得“多余”。有充分的理由表明，与癌症相关的 CS 的情况和情况与与癌症相关的 AS 不同。
