Palliative Care and Social Practice · Published 2026-04-01 · DOI 10.1177/26323524261436925
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 .
Abstract from DOAJ. Public domain (CC0 1.0).
Read the article at the publisher →