Death by Request in Switzerland: Post-traumatic stress disorder and complicated grief after witnessing assisted suicide

A study conducted in Switzerland in December 2007 among 85 family members and friends who were present at an assisted suicide showed higher prevalence of PTSD (Post-Traumatic Stress Disorder) and complicated grief after witnessing assisted suicide than following a natural death. Switzerland is one of the few nations in which assisted suicide is legal. It is generally defined as the prescribing or supplying of drugs with the explicit intention of enabling the patient to end his or her own life. Despite the ongoing debate about assisted suicide, little research has been done on the impact on the loved ones of the dead. The study was conducted in cooperation with Exit Deutsche Schweiz, an organization that facilitates with assisted suicides. The loved ones contacted were found through the organization.
 
The trauma after witnessing an assisted suicide varies significantly from natural death or suicide. According to the study, this is because it often allows for the opportunity to say goodbye and it allows for a more predictable quality of death and the time is predetermined. Nevertheless, the images related to dying itself may cause stress related symptoms.
 
In the study, 13% of bereaved survivors met the criteria for full PTSD, 6.5% for sub threshold PTSD, 4.9% for complicated grief, 6% for anxiety and 16% for depression. Of the respondents 22% were found to have clinically relevant impairments in physical health. Participants in this study showed a higher prevalence of depression. 

This study shows that witnessing the unnatural death of a loved one may have an impact on mental and physical health due to trauma related symptoms and that greater services need to be provided to those family members and friends. It also questions the so-said individual and autonomous nature of a "chosen" death.