Assisted Suicide in Austria: Nurses' Understanding of Patients' Requests and the Role of Patient Symptoms

This study explores Austrian palliative and hospice care nurses' experiences regarding assisted suicide (AS). Following its legalization in 2022, occupational groups affected by the legislation, such as nurses, have been left without clear guidance or instructions on how to navigate this new landscape. This study aimed to explore how nurses perceive their patients' desire to die and its connection to the symptoms experienced by the patients. A cross-sectional online questionnaire survey was disseminated to all palliative and hospice care facilities in Austria and was eventually completed by 145 nurses, focusing on their understanding of patients' requests for AS and the severity of patients' symptoms. Factor analysis was used to identify symptom clusters, and Spearman rank correlations were employed to explore associations between nurses' understanding of AS and factors such as patient symptoms, nurse demographics, and attitudes toward AS. The results indicate that psychosocial factors, particularly loss of dignity (63.6%) and autonomy (76.4%), were the most frequently reported severe symptoms. Understanding patients' decisions was significantly associated with nurses' general support for AS (r = 0.34, p < 0.001) but not with age, work experience, or religious beliefs. Factor analysis revealed four symptom clusters, with 'loss of dignity' showing a small but significant correlation with nurses' understanding of patients' requests (r = 0.17, p = 0.044). The present findings highlight the importance of integrating psychosocial support into palliative care and emphasize the need for clear guidelines and training to better support nurses in managing AS-related challenges.