ArticleBMC medicine2018
Medical end-of-life practices in Swiss cultural regions: a death certificate study.
Article in BMC medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 25 citations in OpenAlex.
- If it were me…. Austrian undergraduate medical students' attitudes towards end-of-life decisions: a cross-sectional study.BMC medical ethics · 2026Article
- Refractory symptoms and end of life midazolam use in cancer patients, a single center experience.Palliative & supportive care · 2025Article
- A closer look at regional differences in euthanasia practices in the Netherlands.Research in health services & regions · 2025Article
- End-of-life medical decisions in French overseas departments: results of a retrospective survey.BMC palliative care · 2024Article
- Should continuous deep sedation until death be legally regulated in Switzerland? An exploratory study with palliative care physicians.Palliative care and social practice · 2023Article
- How should health care providers inform about palliative sedation? A qualitative study with palliative care professionals.European journal of cancer care · 2022Article
- Palliative Sedation-The Last Resort in Case of Difficult Symptom Control: A Narrative Review and Experiences from Palliative Care in Switzerland.Life (Basel, Switzerland) · 2022Review
- Knowledge Gaps in End-of-Life Care and Planning Options Among Older Adults in Switzerland.International journal of public health · 2022Article
- Article
- Implementing advance care planning in early dementia care: results and insights from a pilot interventional trial.BMC geriatrics · 2021Article
- A qualitative study on continuous deep sedation until death as an alternative to assisted suicide in Switzerland.BMC palliative care · 2021Article
- Commonalities and differences in legal euthanasia and physician-assisted suicide in three countries: a population-level comparison.International journal of public health · 2020Article
- Physician-related determinants of medical end-of-life decisions - A mortality follow-back study in Switzerland.PloS one · 2018Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundEnd-of-life decisions remain controversial. Switzerland, with three main languages shared with surrounding countries and legal suicide assistance, allows exploration of the effects of cultural differences on end-of-life practices within the same legal framework.
methodsWe conducted a death certificate study on a nationwide continuous random sample of Swiss residents. Using an internationally standardized tool, we sent 4998, 2965, and 1000 anonymous questionnaires to certifying physicians in the German-, French-, and Italian-speaking regions.
resultsThe response rates were 63.5%, 51.9%, and 61.7% in the German-, French-, and Italian-speaking regions, respectively. Non-sudden, expected deaths were preceded by medical end-of-life decisions (MELDs) more frequently in the German- than in the French- or Italian-speaking region (82.3% vs. 75.0% and 74.0%, respectively), mainly due to forgoing life-prolonging treatment (70.0%, 59.8%, 57.4%). Prevalence of assisted suicide was similar in the German- and French-speaking regions (1.6%, 1.2%), with no cases reported in the Italian-speaking region. Patient involvement was smaller in the Italian- than in the French- and German-speaking regions (16.0%, 31.2%, 35.6%). Continuous deep sedation was more frequent in the Italian- than in the French- and German-speaking regions (34.4%, 26.9%, 24.5%), and was combined with MELDs in most cases.
conclusionWe found differences in MELD prevalence similar to those found between European countries. On an international level, MELDs are comparably frequent in all regions of Switzerland, in line with the greater role given to patient autonomy. Our findings show how cultural contexts and legislation can interact in shaping the prevalence of MELDs.
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