A qualitative study issued in September in the BMJ medical journal covers the motivations of those resorting to assisted suicide in Switzerland, based on detailed interviews conducted on 30 people committed to an assisted suicide procedure. The study shows that the decision to resort to assisted suicide cannot be explained by physical suffering alone, but is the result of a combination of considerations and personal representations of the end of life, such as the will to keep control and to manage the conditions of one's death.
In Switzerland, assistance for suicide (or "assisted suicide") has been authorised since 1942, under highly flexible access conditions: The person resorting to assisted suicide must be capable of discernment, must self-administer the lethal substance and the person assisting must not be prompted by "selfish motives".
Every year, in Switzerland, some 1,800 people resort to assisted suicide, i.e. around 2.5% of the total deaths.
The study published in BMJ by research workers at the Lausanne University hospital centre is based on interviews conducted between October 2023 and July 2025 with 30 adults already committed to an assisted suicide protocol with Swiss associations which provide such assistance.
It is therefore a qualitative study, based on the analysis of the statements by the people interviewed, and not a statistical study intended to measure the frequency of the various motivations throughout the Swiss population.
The study identifies six main findings which interact with one another in the call for assisted suicide.
1 – The will to manage conditions of their own death
For those interviewed, the decision to resort to assisted suicide reflects a certain idea of the end of life, with a desire for autonomy and self-determination.
Several contributors to the survey explained that their desire for assisted suicide preceded their disease. Some were affected by the end of life of a family member and wished to avoid having to get through the same themselves. Moreover, some expressed the will that their family should not witness their deteriorating health and wished to avoid being burdensome.
2 - The perception of assisted suicide as a safe process
An important factor in resorting to assisted suicide is the perception of the practice of assisted suicide in Switzerland as a structured, safe and trustworthy procedure. Those interviewed had full trust in the associations which practice assisted suicide. They consider the Swiss model as one which privileges personal autonomy.
3 – The demand for validation by the entourage
Even if the decision to resort to assisted suicide is accepted as a personal decision, it is often reinforced by the validation of family members, their understanding and their participation in the preparation.
4 – A will to take back control in opposition to the medicalization of the end of life
Those interviewed constantly insisted on the importance of preserving their autonomy and their ability to make decisions on their end of life, as an essential element of their dignity. The ability for self-determination is considered as a "Human right".
Some participants described experiences where they felt they were not properly considered in the thinking undertaken by health professionals. Some reported communication problems and incomprehension with medical staff, which eroded their trust in medicine.
5 – The crossing of a threshold considered to be unbearable
The decision to resort to assisted suicide is associated with a feeling of suffering which is considered as unbearable. The participants mentioned five dimensions of suffering, connected with one another:
- Physical suffering (fatigue, pain, loss of mobility, functional decline)
- Psychological suffering (anxiety, loss of pleasure)
- Existential suffering (feeling of uselessness, loss of purpose…)
- Suffering associated with treatments
- Social suffering (isolation, feeling of a loss of any social role, difficulty in accomplishing everyday tasks).
6 – Fear of missing a "window of opportunity"
Quite often, those interviewed expressed the fear of being unable to resort to assisted suicide if they wait too long, their eligibility for assisted suicide being dependent on their physical and mental capabilities. Such capabilities could be lost as the disease progresses.
Thus, the identification of these six main concerns, which are intertwined, show the importance of personal considerations on autonomy and representations on a desirable way to die in the decision to resort to assisted suicide.
The awareness of time passingalso plays a central role. The perception of a narrowing "window of opportunity" elevates assisted suicide from a simple possibility to an urgent decision. Also included in the decision is the will to shield the family.
These results echo those from other studies conducted previously, in particular a study conducted in France in 2012 on requests expressed by patients for quickening death. This study showed that the main motivations of patients were the fear of being burdensome on family members, of projecting an intolerable image of oneself, the feeling of uselessness and the fear of unbearable suffering.
In Oregon, where assisted suicide is also authorised, the main motivations expressed are the loss of autonomy (92% and the loss of the ability to perform activities which make life agreeable (88%) (2023 report).
In the documentary by Lizz Car broadcast a few months ago, an advocate for the legalisation of euthanasia and assisted suicide clearly stated that the will for legalisation was based essentially on the will for control (rather than in response to suffering) : " There will always be people, even when well looked after in palliative care, who will want to control the process and have the ability to put an end to the process".
The limitations of the study
The study published in BMJ is based on interviews conducted with people already committed to an assisted suicide protocol, with in certain cases a date of death already programmed. This type of research remains quite rare internationally.
Nevertheless, one should consider certain limitations of the survey:
- The sample consisted essentially of women and French-speaking people, which weakens its representativeness.
- Some people were physically weak at the time of the interview, which in some cases led to shorter and less thorough interviews.
- One should not ignore a probable bias in the choice of the sample, since the participants were recruited by health workers and assisted suicide associations (Exit ADMD, Life Circle and Exit Ticino). More vulnerable, isolated people, more hesitant in their decisions or less able to describe their situation, could be under-represented.
- Finally, the research workers interrogated only those who were already committed to an assisted suicide procedure. The study therefore provides no information on those who considered assisted suicide but rejected the idea, or on people as yet undecided.
Additionally, this study is centred on the experience of those committed to the procedure. It would be valuable also to understand the experience of those accompanying them. Anesthesia, the documentary by Damien Boyer, issued in 2026, interviewed those who took part in the assisted suicide of actress Maïa Simon in Switzerland. Although the actress was able to achieve her wishes, the impact on those in attendance of her fatal act is lasting: "The shock afterwards is another matter and one is quite alone with it".
Even if it is not totally representative, the study published in BMJ is unusual in having conducted detailed interviews with people already committed to an assisted suicide procedure in Switzerland. Following other studies in other nations, its results confirm that requests to end one's life cannot be interpreted as the sole result of suffering considered to be unbearable but are linked to various considerations and personal values, such as representations of the good way to die, the wish for control and autonomy till the end and the fear of losing such a possibility later on, if one waits too long.