Hsu Nina Ming-Hsin, Chen Ying-Yeh, Chang Shu-Sen, Chi Ying-Chen, Wu Kevin Chien-Chang
Taipei City Psychiatric Centre, Taipei City Hospital, Taipei City, Taiwan.
Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.
BMC Psychiatry. 2025 Jul 9;25(1):689. doi: 10.1186/s12888-025-07112-8.
In 2019, Taiwan implemented two laws with contrasting implications for suicide-related policies: the Suicide Prevention Act, which mandates government-led interventions to prevent suicide, and the Patient Right to Autonomy Act, which affirms patient rights in end-of-life care, including the refusal of nutrition and fluid that hastens death, but does not explicitly legalize physician-assisted suicide. Public support for legal policies related to these laws may depend on beliefs about suicide. This study examined whether two specific beliefs: (1) that people have the right to die by suicide and (2) that suicide can be a rational act, are associated with support for suicide prevention policies and legal penalties for physician-assisted suicide.
A nationally representative telephone survey (N = 1,087) was conducted in Taiwan in 2020. Two belief items served as key predictors: (1) agreement with the statement "people have the right to suicide" (right-to-suicide belief), and (2) disagreement with the statement "suicide is irrational" (suicide-rationality belief). Logistic regression analyses examined associations between these beliefs and attitudes toward three suicide prevention measures and one policy regarding the legal penalties for physician-assisted suicide. Interaction effects between beliefs were also analyzed.
Support for suicide prevention measures ranged from 85 to 95%, while 29.4% supported legal penalties for physician-assisted suicide in terminally ill patients. The right-to-suicide belief was held by 55.3% of participants and was not significantly related to suicide-prevention attitudes, but was associated with support for penalizing physician-assisted suicide. The suicide-rationality belief, held by 26.3%, was associated with reduced support for suicide prevention policies and greater opposition to penalizing physician-assisted suicide.
While the belief in a right to suicide was common, it did not consistently predict support or opposition to suicide-related laws, suggesting that it may be a broad or ambiguous stance. In contrast, the belief that suicide is rational was linked to clearer, more consistent positions across related policies. Public education and engagement efforts should consider how framing suicide as rational may reduce support for prevention. Approach that incorporates medical, psychological, social, and cultural perspectives may help clarify the boundaries between prevention efforts and respect for patient autonomy.
2019年，台湾实施了两部对自杀相关政策有不同影响的法律：《自杀防治法》，该法规定政府主导干预以预防自杀；以及《病人自主权利法》，该法确认了病人在临终关怀中的权利，包括拒绝加速死亡的营养和液体，但未明确将医生协助自杀合法化。公众对与这些法律相关的政策的支持可能取决于对自杀的看法。本研究调查了两种特定看法：（1）人们有自杀的权利；（2）自杀可以是一种理性行为，是否与对自杀预防政策的支持以及对医生协助自杀的法律处罚相关。
2020年在台湾进行了一项具有全国代表性的电话调查（N = 1087）。两个看法项目作为关键预测因素：（1）同意“人们有自杀的权利”这一说法（自杀权利看法），以及（2）不同意“自杀是不理性的”这一说法（自杀合理性看法）。逻辑回归分析检验了这些看法与对三种自杀预防措施的态度以及一项关于医生协助自杀法律处罚政策之间的关联。还分析了看法之间的交互作用。
对自杀预防措施的支持率在85%至95%之间，而29.4%的人支持对绝症患者的医生协助自杀进行法律处罚。55.3%的参与者持有自杀权利看法，该看法与自杀预防态度无显著关联，但与支持处罚医生协助自杀相关。26.3%的人持有自杀合理性看法，该看法与对自杀预防政策的支持减少以及对处罚医生协助自杀的更大反对相关。
虽然自杀权利看法很普遍，但它并不能一致地预测对自杀相关法律的支持或反对，这表明它可能是一种宽泛或模糊的立场。相比之下，认为自杀是理性的看法与相关政策中更清晰、更一致的立场相关。公众教育和参与工作应考虑将自杀描述为理性如何可能减少对预防的支持。纳入医学、心理、社会和文化视角的方法可能有助于厘清预防工作与尊重患者自主权之间的界限。
