Togolese lay people's and health professionals' views about the acceptability of physician-assisted suicide

Abstract

AIM: To study the views on the acceptability of physician-assisted-suicide (PAS) of lay people and health professionals in an African country, Togo. METHOD: In February-June 2012, 312 lay people and 198 health professionals (75 physicians, 60 nurses and 63 health counsellors) in Togo judged the acceptability of PAS in 36 concrete scenarios composed of all combinations of four factors: (a) the patient's age, (b) the level of incurability of the illness, (c) the type of suffering and (d) the patient's request for PAS. In all scenarios, the patients were women receiving the best possible care. The ratings were subjected to cluster analysis and analyses of variance. RESULTS: Most lay people (59%) were not systematically opposed to PAS, whereas most health professionals (80%) were systematically opposed to it. The most important factors in increasing acceptability among people not systematically opposed were advanced age of the patient and incurability of the illness. Additional acceptability was provided by the patient's request to have her life ended, although much less so than in studies in Western countries, and by suffering characterised by complete dependence rather than by extreme physical pain. CONCLUSIONS: These empirical findings--the first ones gathered in the African continent--suggest that most Togolese lay people are not categorically for or against PAS, but judge its degree of acceptability as a function of concrete circumstances.