LAUSR

Introduction In some Swiss states, right-to-die associations are allowed to assist older people in nursing homes provided that certain requirements are fulfilled. Objectives To investigate how health and social care providers and their institutions reacted to and dealt with requests of assisted suicide. Method An exploratory qualitative study was carried out in the States of Fribourg and Vaud among 40 professionals working in nursing homes, home care services or social welfare agencies. Results The requests of assisted suicide questioned the professional mission, the quality of accompaniment provided to the older people and both professional and personal values. Health and social care providers were required to ponder over ethical dilemmas or decisions. Several challenges were reported, such as: taking into account and articulating personal freedom or needs with collective functioning or organizational constraints before, during and after the assisted suicide; reconciliating self-determination with protection towards vulnerable people (beneficere, non maleficere). Conclusions Assisted suicide challenges and changes professional end-of-life practices. Education and support should be provided to health and social care providers faced with it. Disclosure of interest The authors have not supplied their declaration of competing interest.