Increase in assisted suicide in Switzerland: did the socioeconomic predictors change? Results from the Swiss National Cohort
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OBJECTIVE: To determine whether the strong increase in assisted suicides in Switzerland since 2008 is linked to a shift in the socioeconomic factors associated with assisted suicide and its related diagnoses. METHODS: In a population-based longitudinal study, we investigated assisted suicides in Switzerland over the period 2003-2014. Two groups of younger (25-64 years) and older (65-94 years) persons were analysed separately and compared. We calculated crude rates and used Cox proportional hazard and logistic regression models to examine associations of assisted dying with gender, marital status, education, religion, neighbourhood socioeconomic status and other variables, and investigated trends over time. RESULTS: We identified 3941 assisted suicides among 6 237 997 Swiss residents, 80% of which occurred in the older age group. Crude rates of assisted suicide more than tripled during the study period from 3.60 to 11.21 per 100 000 person-years; the increase was more pronounced in the older age group. Cancer was the most common underlying diagnosis (41.8%), but the percentage dying assisted was highest among patients with diseases of the nervous system (5.25% in the younger and 1.23% in the older age group). The factors associated with assisted suicide did not change during the study period. Female gender, higher education, having no religious affiliation, no children and a Swiss passport, living in a neighbourhood with a higher socioeconomic index and living in the French-speaking part of Switzerland were associated with a higher rate. CONCLUSIONS: The study results do not indicate any shift in socioeconomic factors associated with assisted suicide, but a more pronounced increase in incidence among the elderly.
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Very few studies have been published on cases of psychiatric euthanasia in Switzerland, and those that exist often do not specify the psychiatric diagnoses of patients who underwent assisted suicide.
“Very few studies have been published on cases of psychiatric euthanasia in Switzerland, and those that exist often do not specify the psychiatric diagnoses of patients who underwent assisted suicide (18, 20, 64, 93).”
From Assisted death in eating disorders: a systematic review of cases and clinical rationales (2024) · cites this paper as [93]
The Results (Diagnoses) report mental and behavioural disorders among Swiss assisted suicides and identify mood disorders and dementia, but do not assess how many studies of psychiatric cases have been published or whether other studies specify patients’ diagnoses. The Introduction distinguishes assisted suicide from euthanasia and states that euthanasia is prohibited in Switzerland. A search for psychiatric diagnoses and the claimed scarcity of studies found no passage making the attributed literature-wide claim. (LLM, conf=0.76)
Experimental — accuracy not yet measuredLoneliness has been identified as a predictive factor of assisted suicide in Switzerland.
“loneliness has been identified as a predictive factor of assisted suicide in Switzerland.35”
From “Nothing Hurts Less Than Being Dead”: Psychological Pain in Case Descriptions of Psychiatric Euthanasia and Assisted Suicide from the Netherlands: « Rien ne fait moins mal qu’être mort »: La douleur psychologique dans les descriptions de cas d’euthanasie et de suicide assisté psychiatrique aux Pays-Bas (2020) · cites this paper as [35]
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- Authors
- Steck, N., Junker, C., & Zwahlen, M.
- Affiliations
- University of Bern (CH)
- Federal Statistical Office (CH)
- Corresponding author
- Steck, Nicole
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2018-04
- Volume
- 8
- Issue
- 4
- Pages
- e020992
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC5905761
- OpenAlex
- W2802886894
- Cited by
- 82
- References
- 26
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 6 · 2023: 9 · 2022: 32 · 2021: 11 · 2020: 4 · 2019: 9 · 2018: 1
- FWCI
- 7.34
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- BORIS (University Library Bern) (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Open Access CRIS of the University of Bern
- Funders
- Swiss National Science Foundation
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- assisted suicide, assisted dying, socioeconomic predictors, older adults, cancer, neurological disorders, gender differences, marital status, neighborhood socioeconomic status, French-speaking Switzerland, Switzerland, incidence trends
- MeSH terms
- Adult, Aged, Aged, 80 and over, Female, Humans, Longitudinal Studies, Male, Middle Aged, Residence Characteristics, Socioeconomic Factors, Switzerland, Suicide, Assisted, Censuses
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