Development of a Questionnaire to Determine Incidence and Attitudes to “Voluntary Stopping of Eating and Drinking”

Journal of Pain and Symptom Management

Büche

Häuptle

et al. 2021

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Context. Voluntary stopping of eating and drinking (VSED) is the self-determined decision of an individual with the decision-making capacity to cause premature death. During the course of VSED, the person is dependent on the support of relatives and health professionals. To date, little is known of the attitudes of Swiss health professionals on this topic.Objectives. The objective of this study was to assess the experiences, personal attitudes, and professional stances of Swiss health care professionals toward VSED.Methods. We conducted a nationwide cross-sectional survey by questioning family physicians and the heads of outpatient care and long-term care (e.g., nursing directors, institute directors, or head nurses) about VSED (n ¼ 1681; response rate 40.1%). Descriptive data analysis and hypothesis testing (occupational group, age, sex, professional years, VSED experience, and regions) were subsequently conducted.Results. Individuals who are willing to die are granted the right to professional accompaniment during VSED (agreement 97.8%), and their death is usually classified as a natural form of dying (63.5%) and only rarely (5.4%) as suicide. Family physicians have significantly more moral concerns during accompaniment compared with the heads of outpatient and longterm care (P < 0.001).Conclusion. Swiss health care professionals support the autonomy and self-determination of patients, which is also reflected in their positive attitude toward VSED, even if they have moral reservations when accompanying patients.

Section: Data Collectionmentioning

confidence: 99%

Experiences, Personal Attitudes, and Professional Stances of Swiss Health Care Professionals Toward Voluntary Stopping of Eating and Drinking to Hasten Death: A Cross-Sectional Study

Journal of Pain and Symptom Management

Büche

Häuptle

et al. 2021

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“…We developed an evidence-based questionnaire (Stängle et al, 2019d) as part of a mixed-methods project according to our research protocol (Stängle et al, 2018). We wanted to determine the occurrence of and attitudes toward VSED among health professionals; this was used in this cross-sectional study.…”

Section: Methodsmentioning

confidence: 99%

“…This study used a questionnaire (Stängle et al, 2019d) that was based on a literature search and was psychometrically tested after development (Colton & Covert, 2007; Polit & Beck, 2006; Polit et al, 2007) and then translated from German into French and Italian (Acquadro et al, 2012; Mahler & Reuschenbach, 2011). We developed a questionnaire with 41 items to record the occurrence of the VSED and the experiences, attitudes, and stances about it.…”

Section: Methodsmentioning

confidence: 99%

Voluntary Stopping of Eating and Drinking in Swiss Outpatient Care

Schnepp²,

Büche

et al. 2021

GeroPsych

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Abstract. Besides physician-assisted suicide, there is another end-of-life practice under discussion: voluntary stopping of eating and drinking (VSED). In this study, we assess the occurrence of VSED in outpatient care and evaluate nurses’ attitudes about it. We recruited 395 nurses (24% response rate) in our online survey. The occurrence of VSED in Switzerland lies at 0.5%. Most nurses (84.6%) were aware of VSED, and 39.5% had experienced it with patients. VSED was mostly (70.3%) regarded as a natural death, and nearly all (95.1%) were willing to care for these patients; however, about one-quarter (26.5%) expressed moral concerns. Our results show that VSED occurs in rare cases, and that nurses are willing to accompany patients during this VSED, but express moral concerns.

“…All items had an item-CVI value greater than 0.90 and a scale-CVI of 0.97, which corresponds to excellent values. The literature review, and the development, psychometric testing (43)(44)(45) and the forward/backward translation (46) (from German into French, Italian, and English) of the questionnaire and the questionnaire itself has been published (47). A questionnaire with 41 items was developed to record the occurrence of the VSED and the experiences, attitudes and stances about it.…”

Section: Design Participants and Statistical Analysis Of The Surveymentioning

confidence: 99%

Perspectives of people accompanying a person during voluntary stopping eating and drinking: a convergent mixed methods study

Fringer

2021

Ann Palliat Med

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Background: Voluntary stopping eating and drinking (VSED) is an option for people wishing to bring about premature death. In Switzerland, VSED is considered a controversial action at the end of life in the guidelines for "Management of dying and death," which states that the decision to support or oppose VSED must be made individually by health care professionals; so far there are no instructions for action. The aim of this research was to explore the experiences of people who play an important role in VSED accompaniment, and to explain how the people involved in the process deal with VSED.Methods: This convergent mixed methods study included a national survey (n=1,681) and five focus group interviews (n=47). Data integration was conducted using the four-stage pillar integration process.Results: Given Swiss society interest, VSED has already established itself in the health system without the institutions having addressed the issue, whereupon health professionals make individual decisions when a person willing to die comes to them with a VSED wish. Health professionals are open to VSED, but are also ambivalent and would like to know more about it before being confronted with a VSED case. Conclusions:In Switzerland, VSED has become a rare but desired option for ending life prematurely.While health professionals are already being confronted with the phenomenon, there is a lack of discussion at the level of health institutions about how to deal with it.