Objective: To determine the prevalence of patients with parkinsonian syndromes who performed assisted suicide (AS) at DIGNITAS in Switzerland from 2006 till 2012 and to analyze the underlying motivations.

Background: Atypical Parkinsonian Disorders (APD) like Progressive Supranuclear Palsy (PSP), Multiple System Atrophy (MSA) and Corticobasal Syndrome (CBS) lead to progressive physical and mental impairment. Therefore, in these patients suicidal ideation is high.

In Parkinson Disease (PD) reported prevalence of the wish to die is 20%, suicidal ideation occurs in 7%. There are no data about suicidal ideation in APD.

Assisted suicide is not allowed in Germany, but in Switzerland. Therefore, we have analyzed the prevalence of APD/PD in patients, who performed assisted suicide (AS) at DIGNITAS in Switzerland from 2006 till 2012 and have focused on the motivation behind the wish of hastened death.

Methods: We scanned DIGNITAS-Files from 2006 till 2012 for Patients with Parkinson’s Disease (PD), PSP, MSA and CBS. We recorded demographic data and the dates of the different steps that must be taken before one is granted AS. Medical data was collected from medical reports and from the applicant‘s own description of daily life. Furthermore, we qualitatively have investigated the motivation letters which have tob e prepared before assited suicide will be performed.

Results: From 2006 till 2012, 72 people with parkinsonian disorders performed AS. We noted a high prevalence of APS (53%). Of note, >50% of applicants were married or in a relationship, 68% had children, and 89% did not receive AS alone, indicating a high level of acceptance of the applicant’s decision in friends and family members. The main motivation drawn from the letters has been 1) being a burden fort he family, 2) the physicians have given up on me, 3) I will loose my dignitiy and autonomy during the course of the disease.

Conclusions: In Europe, PD and APD patients make use of AS and the wish for hastened death is supported by the family and friends. The wish for AS in APD is most common not at the onset of symptoms, but shortly after diagnosis. Therefore, we propose and early and continuous integration of palliative care knowledge to address the patients burden and to respect dinity and autonomy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/assisted-suicide-of-patients-with-parkinsonian-syndromes-in-switzerland-the-need-of-early-and-continuous-integration-of-palliative-care-and-dignitiy-therapy/