Psycho-oncologists' roles, tasks, and needs regarding requests for assisted suicide - a qualitative interview study on current experiences and future directions

心理肿瘤学家在协助自杀请求中的角色、任务和需求——一项关于当前经验和未来方向的定性访谈研究

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Abstract

PURPOSE: Assisted suicide (AS) is a socio-political and healthcare challenge. In Germany, AS is legal, with further regulation pending. Previous German legislation drafts proposed involving psychosocial professionals like psycho-oncologists. These are experienced in supporting seriously ill patients and end-of-life decisions. However, there is a lack of studies on their role in AS. This study aimed to explore psycho-oncologists' current and future roles, tasks, and needs regarding AS requests. METHODS: We conducted a cross-sectional, qualitative interview study with psycho-oncologists in Germany. Inclusion criteria were current clinical activity as a psycho-oncologist and having talked to at least one patient about AS. Invitations to participate were distributed via email and social media using the study team's network. Interested participants responded voluntarily (convenience sample). Data were analyzed using Practical Thematic Analysis and qualitative content analysis. RESULTS: Twelve interviews were conducted (average length of 42 min). Participating psycho-oncologists (58% female, 50% up to 40 years, 91.7% psychological and 8.3% medical professional background) primarily saw themselves as open-minded conversation partners, both currently and in the future. Opinions differed as to whether psycho-oncologists should assess decision-making capacity. The vast majority rejected participation in the actual act of ending one's life. They opposed psycho-oncologists having to fulfill mandatory tasks in the context of AS. Key needs for engaging in AS-related work included clinical practice guidelines, legal clarity, and specific training opportunities. CONCLUSION: This study provides initial insights into (potential) roles, tasks, and needs of psycho-oncologists in AS requests. It can serve as a basis for follow-up studies. Suitable structures and training opportunities should be developed.

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