Abstract
BACKGROUND: In 2019, Taiwan implemented two laws with contrasting implications for suicide-related policies: the Suicide Prevention Act, which mandates government-led interventions to prevent suicide, and the Patient Right to Autonomy Act, which affirms patient rights in end-of-life care, including the refusal of nutrition and fluid that hastens death, but does not explicitly legalize physician-assisted suicide. Public support for legal policies related to these laws may depend on beliefs about suicide. This study examined whether two specific beliefs: (1) that people have the right to die by suicide and (2) that suicide can be a rational act, are associated with support for suicide prevention policies and legal penalties for physician-assisted suicide. METHODS: A nationally representative telephone survey (N = 1,087) was conducted in Taiwan in 2020. Two belief items served as key predictors: (1) agreement with the statement "people have the right to suicide" (right-to-suicide belief), and (2) disagreement with the statement "suicide is irrational" (suicide-rationality belief). Logistic regression analyses examined associations between these beliefs and attitudes toward three suicide prevention measures and one policy regarding the legal penalties for physician-assisted suicide. Interaction effects between beliefs were also analyzed. RESULTS: Support for suicide prevention measures ranged from 85 to 95%, while 29.4% supported legal penalties for physician-assisted suicide in terminally ill patients. The right-to-suicide belief was held by 55.3% of participants and was not significantly related to suicide-prevention attitudes, but was associated with support for penalizing physician-assisted suicide. The suicide-rationality belief, held by 26.3%, was associated with reduced support for suicide prevention policies and greater opposition to penalizing physician-assisted suicide. CONCLUSIONS: While the belief in a right to suicide was common, it did not consistently predict support or opposition to suicide-related laws, suggesting that it may be a broad or ambiguous stance. In contrast, the belief that suicide is rational was linked to clearer, more consistent positions across related policies. Public education and engagement efforts should consider how framing suicide as rational may reduce support for prevention. Approach that incorporates medical, psychological, social, and cultural perspectives may help clarify the boundaries between prevention efforts and respect for patient autonomy.