The request for assisted suicide – a challenging topic to teach in medical education. Project report on a compulsory elective course at the Aachen University Hospital

Abstract

Aim: As part of the Erasmus+ project “ELPIS”, a compulsory elective course in palliative medicine on handling wishes to die and the desire for suicide was put into place and offered for the first time at the Clinic for Palliative Medicine at RWTH Aachen University in the 2023 summer semester, both as a classroom-based session and an online session. The aim of this project was to provide students with background knowledge, skills and the opportunity to stake out a position in the ongoing debate on assisted suicide. Method: The course was initially offered to 15 students in a classroom-based format and entailed 120 minutes during which an introductory lecture and an interactive conversation with a simulated patient were held. A pseudonymized online evaluation took place. In addition to 4 items to collect demographic data, the focus was specifically on capturing personal attitudes toward and knowledge about assisted suicide (6 items). The survey also described the global outcome (4 items) and measured gain in learning on the levels of knowledge, skills and attitude (8 items). Results: The evaluation showed that assisted suicide is viewed as a form of medical care, but suggests at the same time that there are knowledge deficits concerning end-of-life alternatives. The students’ self-assessed level of preparedness increased as a result of the intervention, while their fear of being confronted with a wish for assisted suicide decreased. The opportunity to take up a dynamic stance using an athletic playing field as an aid was perceived as helpful. The specific outcome evaluation showed a gain in learning in all of the dimensions. Conclusion: The participants displayed an open attitude toward assisted suicide as a form of medical care. At the same time, they felt unprepared and fearful of the responsibility that comes with receiving requests for assisted suicide. In order to gain a better understanding of the students’ perspectives and fears, a comparative analysis of the digital course and semi-structured student interviews are currently underway.

Keywords

• assisted suicide
• palliative medicine
• medical education
• professional identity formation