Citation

Steck N, Junker C, Maessen M, Reisch T, Zwahlen M, Egger M. Int. J. Epidemiol. 2014; 43(2): 614-622.

Copyright

(Copyright © 2014, International Epidemiological Association, Publisher Oxford University Press)

DOI

10.1093/ije/dyu010

PMID

unavailable

Abstract

BACKGROUND: In Switzerland, assisted suicide is legal but there is concern that vulnerable or disadvantaged groups are more likely to die in this way than other people. We examined socio-economic factors associated with assisted suicide.

METHODS: We linked the suicides assisted by right-to-die associations during 2003-08 to a census-based longitudinal study of the Swiss population. We used Cox and logistic regression models to examine associations with gender, age, marital status, education, religion, type of household, urbanization, neighbourhood socio-economic position and other variables. Separate analyses were done for younger (25 to 64 years) and older (65 to 94 years) people.

RESULTS: Analyses were based on 5 004 403 Swiss residents and 1301 assisted suicides (439 in the younger and 862 in the older group). In 1093 (84.0%) assisted suicides, an underlying cause was recorded; cancer was the most common cause (508, 46.5%). In both age groups, assisted suicide was more likely in women than in men, those living alone compared with those living with others and in those with no religious affiliation compared with Protestants or Catholics. The rate was also higher in more educated people, in urban compared with rural areas and in neighbourhoods of higher socio-economic position. In older people, assisted suicide was more likely in the divorced compared with the married; in younger people, having children was associated with a lower rate.

CONCLUSIONS: Assisted suicide in Switzerland was associated with female gender and situations that may indicate greater vulnerability such as living alone or being divorced, but also with higher education and higher socio-economic position. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Language: en

Keywords

Humans; Gender; Adult; Aged; Female; Male; Middle Aged; adult; human; Cause of Death; suicide; female; male; epidemiology; Sex Distribution; Aged, 80 and over; aged; Vulnerability; Educational Status; Longitudinal Studies; Cohort study; assisted suicide; public health; cause of death; Marital Status; heart failure; Religion; longitudinal study; higher education; neighborhood; article; major clinical study; rural area; controlled study; personality disorder; sex ratio; socioeconomics; marriage; priority journal; middle aged; groups by age; religion; terminal care; breast cancer; leukemia; Suicide, Assisted; right to die; Right to Die; Switzerland; Assisted suicide; cohort analysis; logistic regression analysis; digestive system cancer; death certificate; vulnerability; Catholicism; educational status; socioeconomic impact; household; urbanization; health risk; population based case control study; statistics and numerical data; End of life care; very elderly; respiratory tract tumor; divorced person; retinoblastoma