Background: Physician-assisted suicide (PAS) is an important subject of the public debate. So far, legal regulations exist in the Netherlands, Belgium and in Oregon (USA). This review reports results of nine empirical studies from Japan, the Netherlands, the United Kingdom and the U. S. which examine attitudes of psychiatrists toward PAS.
Results: The approval of PAS by psychiatrists varies between the four countries (40 - 69 %). Comparisons with the attitudes of other physicians show a greater agreement among the psychiatrists. A psychiatric examination in order to evaluate competence even in patients with severe somatic illness was advocated by the majority of psychiatrists.
Conclusion: Psychiatrists' attitudes toward PAS vary and are compared with other medical specialties, as well as in different legal and cultural contexts. Therefore, and because of missing empirical studies, results can not be transferred into the context of German speaking countries easily. So far, no acknowledged criteria for the assessment of competence exist. Further empirical research is needed on German psychiatrists' attitudes towards PAS and on competence assessment at the end of life. It remains an open question how legal changes and future developments of palliative care will influence attitudes toward PAS.