[Assisted suicides in Bavaria from 2020 to 2023-the first results from the multiple cause of death statistics]

Assisted suicide (AS) is permitted in Germany under certain conditions. To date, figures on AS in Germany are only available from Munich. The aim of this study is to collect data on AS cases involving residents of Bavaria, including sociodemographic characteristics, existing medical conditions, and drugs used.

The retrospective analysis for the years 2020 to 2023 is based on the information provided in the death certificate, which leads to the official cause of death statistics of the Bavarian State Office for Statistics and represents the total of all deceased persons residing in Bavaria.

A total of 316 AS cases were identified in Bavaria. The AS rate increased from 0.1 to 1.3 deaths per 100,000 inhabitants during the study period. In 2023, AS accounted for almost 1 in 10 suicides in Bavaria and for 0.1% of all deaths. Almost two thirds of AS cases were female. Around half were between 65 and 84 years old. Almost a third suffered from neurodegenerative diseases and around a quarter from cancer. In addition, mental illness was documented in 7% of AS cases, with dementia and affective disorders being present in a third of these cases, respectively. AS in neurodegenerative diseases had a low mean age at death of 70.9 years. At 88.6%, thiopental was the most commonly used drug. Chloroquine, propofol, or phenobarbital were used less frequently.

The number of AS cases in Bavaria is constantly increasing and now accounts for 0.1% of all deaths, which underlines the relevance of the topic for society as a whole. As AS seems to be of particular importance for patients with neurodegenerative and cancer diseases, suicide prevention should focus on these vulnerable groups.