[Knowledge and attitudes toward assisted suicide : Survey of members of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI)].

BACKGROUND

The ban on assisted suicide "intended as a recurring pursuit" was lifted by the German Federal Constitutional Court in 2020. Consequently, the German Medical Council repealed § 16 sentence 3 of the (model) professional code ("They [doctors] may not provide assistance for suicide"). Two legislative proposals to regulate assisted suicide failed in the German Bundestag in 2023. To date, medical staff lack a basis for action when dealing with patients who wish to die. The opinions, attitudes and perspectives of professional groups are important with regard to assisted suicide in order to be able to draw up practical regulations that can be implemented in everyday medical practice.

OBJECTIVES

The aim of this survey is to assess the knowledge about the legal situation in Germany as well as perceptions and attitudes towards assisted suicide among members of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI).

MATERIALS AND METHODS

The study group developed a questionnaire in repeated interdisciplinary and multiprofessional discussions based on a literature review and a previous survey among younger physicians. The questionnaire consisted of questions on the legal and statutory situation of assisted suicide in Germany, personal attitudes and demographic data. It was distributed via the DGAI member newsletter using an online link.

RESULTS

From 08/2023-01/2024, out of 25,573 reachable members, 1056 viewed the survey (view rate: 4%), 822 participated, of which 686 completed the questionnaire (completion rate: 83%). Of all participants, 99% (n = 676/686) were physicians; 56% (n = 385/686) were older than 50 years. 45% (n = 310/686) of participants stated that they were aware of the judgment on the invalidity of section 217 of the German criminal code. 86% (n = 589/686) of respondents incorrectly believed that it is prohibited in Germany to offer assisted suicide intended as a recurring pursuit and 21% (n = 142/686) of respondents falsely believed that assisted suicide is a criminal offense in Germany. 77% (n = 527/686) would prefer a new legal regulation on assisted suicide in order to achieve greater legal certainty. 55% (n = 374/686) stated that healthcare workers are the appropriate point of contact to decide on the permissibility of assisted suicide. Of all respondants, 45% (n = 305/686) have asked patients about the existence of death wishes in their professional career; 23% (n = 159/686) of respondents have never done so. 71% (n = 486/686) declined to participate in assisted suicide for patients regardless of the health condition; 65% (n = 443/686) indicated they could only envision participation in a palliative care setting.

CONCLUSIONS

Participating members of the DGAI show a lack of knowledge regarding the current legal framework surrounding assisted suicide in Germany. They express the hope that future legal regulations will provide legal certainty in this sensitive area. The findings of this study highlight the complexity inherent in the issue of assisted suicide. Subsequent research and policy development should focus on addressing the needs and challenges faced by clinicians and patients, while fostering the establishment of clear guidelines and regulatory frameworks to ensure the provision of safe and ethically responsible care.