Togolese Lay People’s and Health Professionals’ Views about the Acceptability of Physician-Assisted Suicide

Aim: To study the views of lay people and health professionals in an African country, Togo, of the acceptability of physician-assisted-suicide (PAS). Method: In February-June 2012, 322 lay people and 198 health professionals (75 physicians, 60 nurses, and 63 health counselors) in Togo judged the acceptability of PAS in 36 concrete scenarios composed of all combinations of four factors: (a) the patient’s age, (b) the level of incurability of the illness, (c) the type of suffering, and (d) the patient’s request for PAS. In all scenarios, the patients were women who were receiving the best possible care. The ratings were subjected to cluster analysis and analyses of variance. Results: The majority of lay people (59%) were not systematically opposed to PAS, whereas the majority of health professionals (80%) working in the same area were opposed to it. The most important factors in increasing acceptability among people who were not systematically opposed were advanced age of the patient and untreatability of the illness. Additional acceptability was provided by the patient’s request to have her life ended, although much so less than in studies in Western countries, and suffering characterized by complete dependence rather than by extreme physical pain. Conclusion: These empirical findings --the first ones gathered in the African continent-- suggest that most Togolese lay people are not categorically for or against PAS, but judge its degree of acceptability as a function of concrete circumstances. Keywords: Physician-assisted suicide; Acceptability; Empirical study; Scenarios; Tog