[Care-related questions for specialized outpatient palliative care teams when faced with requests for assisted...

Following the repeal of § 217 of the German Criminal Code in early 2020, new related challenges have also emerged in specialized outpatient palliative care (SAPV) regarding how to address requests for assisted suicide that have so far received little systematic investigation. The aim of this study is to describe and analyze cases involving requests for assisted suicide within SAPV. On this basis, key challenges in care are identified and potential strategies for dealing with such requests are developed.

A retrospective case analysis was conducted of all patients who were cared for by the SAPV team at the University Hospital Cologne between February 2020 and August 2025 and explicitly expressed a wish for assisted suicide. Data were extracted from the electronic documentation system (PalliDoc®). Practical and ethical issues related to care were derived within the multiprofessional team.

A total of six patients were included. Five patients suffered from amyotrophic lateral sclerosis and one patient had advanced oncological disease. Three patients made use of external assisted suicide services.

Central challenges in care concerned clarification of the role of SAPV, communication about assisted suicide, support of relatives, and the conclusion of care. A clear internal organizational position, as well as defined communication pathways within the team towards patients and their relatives, proved to be supportive. This study formulates practice-relevant questions for the conceptual further development of approaches to requests for assisted suicides.