This study explores Austrian palliative and hospice care nurses’ experiences regarding assisted suicide (AS). Following its legalization in 2022, occupational groups affected by the legislation, such as nurses, have been left without clear guidance or instructions on how to navigate this new landscape. This study aimed to explore how nurses perceive their patients’ desire to die and its connection to the symptoms experienced by the patients. A cross-sectional online questionnaire survey was disseminated to all palliative and hospice care facilities in Austria and was eventually completed by 145 nurses, focusing on their understanding of patients’ requests for AS and the severity of patients’ symptoms. Factor analysis was used to identify symptom clusters, and Spearman rank correlations were employed to explore associations between nurses’ understanding of AS and factors such as patient symptoms, nurse demographics, and attitudes toward AS. The results indicate that psychosocial factors, particularly loss of dignity (63.6%) and autonomy (76.4%), were the most frequently reported severe symptoms. Understanding patients’ decisions was significantly associated with nurses’ general support for AS (r = 0.34, p < 0.001) but not with age, work experience, or religious beliefs. Factor analysis revealed four symptom clusters, with ’loss of dignity’ showing a small but significant correlation with nurses’ understanding of patients’ requests (r = 0.17, p = 0.044). The present findings highlight the importance of integrating psychosocial support into palliative care and emphasize the need for clear guidelines and training to better support nurses in managing AS-related challenges.

Assisted suicide, also known as physician-assisted death, remains a contentious issue for healthcare providers, involving medical ethics, legal frameworks, and individual rights. This study aims to explore the attitudes, experiences, and training needs of nurses in Austria following the legalization of assisted suicide in 2022. Utilizing a cross-sectional online survey, both quantitative and qualitative data were collected from 280 palliative and hospice care nurses across all nine Austrian states. Approximately a quarter of nurses experienced a shift in their attitudes towards assisted suicide during the first year of its legalization. While a majority felt their wellbeing was unaffected, 14.5% reported a decline in mental health due to the new law. Despite both mandatory and optional training being provided by employers, 80.7% of nurses expressed a need for further education, particularly on legal and organizational aspects, practical case studies, and interdisciplinary communication. Qualitative analysis revealed diverse perspectives, with some nurses advocating for patient autonomy and empathetic support, while others preferred enhancing palliative care as an alternative to assisted suicide. Furthermore, nurses highlighted the necessity for a clear legal framework and collaborative decision-making processes. The study underscores the critical role of comprehensive palliative care and calls for more clarity around appropriate assisted suicide practices. Ongoing dialogue, enhanced training, and support for nurses to navigate both ethical and practical challenges posed by assisted suicide legislation is also needed. Future research should evaluate the effectiveness of these interventions and explore the long-term impacts of assisted suicide on patients, their families, and healthcare providers.

Background: Austria has only recently established a legal framework for assisted dying. Individuals seeking assistance in suicide must navigate a multistage process that has been criticized for its complexity both for the individuals seeking assistance and for the health care and legal professionals involved in the procedure. Objective: To address the critical gap in empirical research that sheds light on the law’s implementation and its impact on the lived experiences of those involved, as well as on the broader health care sector, we have designed an evaluation that examines the various perspectives of individuals seeking assisted suicide; their family members and other relatives; and all professionals specified in the legal framework—notably physicians, notaries and other relevant legal professionals, pharmacists, and psychologists. Methods: Our study uses an interdisciplinary approach that integrates theories, concepts, and methodologies from legal science, ethics, and social science. The legal and ethical components examine aspects of the Austrian legal framework, such as the legal foundations, moral implications, and ethical challenges involved in assisted dying. The main part of this study lies in its comprehensive social science section, which consists of 2 online cross-sectional surveys. The surveys assess sociodemographic characteristics, knowledge and understanding of the framework, encounters and experiences with assisted suicide, and reported need for support and information on the legalization of assisted suicide. In parallel, we are in the process of conducting semistructured in-depth interviews with (1) individuals seeking assistance in dying, (2) family members and other relatives of the individuals seeking assistance in dying, and (3) professionals mentioned in the legal framework (eg, physicians). Thematic analysis will be used to interpret the interview data. Results: The initial research proposal received approval from the University of Vienna Ethics Committee in November 2023. The legal and ethical analyses are ongoing. Recruitment for interview participants began in January 2024. In total, 49 participants have been interviewed as of February 2026. Given the novelty of the legislation and the limited practical experience to date, further interviews are scheduled until April 2026. Data collection for both surveys took place from June to October 2024. The final samples consisted of 239 medical and nursing directors and 304 physicians. Data analysis was completed in May 2025. Completion and dissemination of all study components are anticipated by the end of 2026. Conclusions: Our multiperspective evaluation aims to assess the framework on assisted suicide in Austria. By evaluating the perspectives of relevant key stakeholders, we aim to provide a nuanced understanding of the law’s societal, legal, and ethical implications.

Introduction: This study examines the lived experiences of family caregivers navigating the legal and emotional complexities of Austria's newly enacted Dying Decree Law. Methods: A qualitative interview study was conducted with nine family caregivers (eight women) of people seeking assisted suicide (PSAS) in Austria. Participants were recruited through purposive sampling through multiple recruitment channels. Interviews were analysed using thematic analysis (supported by MAXQDA). Results: Seven overarching themes emerged: (1) Dynamics of Dying and Saying Goodbye; (2) Inclusion versus Exclusion in the Decision‐Making Process; (3) Role Negotiation and Responsibilities; (4) Bureaucratic and Legal Barriers; (5) Social Exclusion and Stigmatisation; (6) Support Needs and Structures; and (7) Ramifications in the Post‐Mortem Phase. Family caregivers reported a lack of formal guidance, often leading to isolation and exhaustion. Open communication was repeatedly highlighted as essential in order to honour the PSAS's wishes and alleviate family caregivers' grief. Conclusion: Family caregivers function as advocates and bureaucratic managers while simultaneously serving as carers who provide the PSAS with physical and emotional support. Rather than relying on the legal framework alone, public policy should also formally acknowledge this dual role and deliver government‑led structural support for family caregivers to lessen their emotional and bureaucratic burden. Patient or Public Contribution: Family caregivers of PSAS were central to this research. We interviewed family caregivers about their experiences with assisted dying under Austria's Dying Decree Law, and incorporated their suggestions for addressing the identified challenges and improving support structures. Their contributions were integral to the study's findings and its focus on enhancing support structures for family caregivers within assisted dying systems.

Background: On 1 January 2022, assisted suicide became legal in Austria with the enactment of the Dying Decree Law (Sterbeverfügungsgesetz, StVfG). This law has posed complex practical and ethical challenges for nursing facilities and hospitals. Medical and nursing directors are tasked with guiding their staff amidst legal uncertainties, emotional burdens, and limited institutional dialogue. Objectives: This study aimed to assess directors’ self-reported knowledge of the law, their experiences managing assisted suicide requests, their perceived adequacy of support in navigating the legal framework, and the presence of institutional guidelines. Design: A cross-sectional mixed-methods study. Methods: An online questionnaire was used to collect data from 239 medical and nursing directors across all nine federal states of Austria (mean age = 49.5 years, SD = 8.5; 65.7% female, 32.2% male; 23.7% working in faith-based institutions, 61.9% in non-faith-based institutions, and 14.4% prefer not to disclose). Quantitative data were analysed using chi-square tests, t tests, and ANOVAs, while thematic analysis was applied to open-ended responses. Results: 44.0% of directors knew the regulations of the Dying Decree Law but were insecure in regards to the application in practice, while 13.4% of directors reported no familiarity with Law at all. Legal familiarity correlated with gender ( p = 0.020, V = 0.183) and institutional religious affiliation ( p = 0.019, V = 0.197). Satisfaction with institutional guidelines was linked to gender ( p = 0.004, r = 0.15), religious affiliation ( p = 0.003, r = −0.15), and institution type ( p = 0.011, η² = 0.126). While 36.2% reported no institutional guidelines on assisted suicide, 13.8% were unaware of their existence. Conclusion: The findings reveal knowledge gaps, institutional disparities, and limited guidance on the Dying Decree Law. Directors report insufficient preparedness, highlighting the need for clearer institutional guidelines and enhanced legal, ethical, and psychological support. Trial registration: This study was registered in the Open Science Framework (OSF) at https://osf.io/bgpsa .