Institutional Challenges in Responding to Austria’s Dying Decree Law: An Evaluation from the Perspectives of Nursing and Medical Directors

Autor(en): Tamina-Laetitia Vielgrader, Jana Marica Hluch, Klara Doppler, Elisabeth Lucia Zeilinger, Ricarda Nater-Mewes, Sabine Parrag, Thomas Wochele-Thoma, Maria Kletecka-Pulker, Stefan Dinges
Abstrakt: 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 analyzed using chi-square tests, t-tests, and ANOVAs, while thematic analysis was applied to open-ended responses.
Results:
Only 13.4% of directors reported familiarity with the Dying Decree Law. Legal familiarity correlated with gender (p = .020, V = 0.183) and institutional religious affiliation (p = .019, V= 0.197). Satisfaction with institutional guidelines was linked to gender (p = .004, r = 0.15), religious affiliation (p = .003, r = -0.15), and institution type (p = .011, η² = 0.126). While 36.2% reported no institutional guidelines on assisted suicide, 13.8% were unaware of their existence.
Conclusions:
Significant knowledge gaps, institutional disparities, and a lack of standardised guidance on Austria’s Dying Decree Law were identified. Directors feel insufficiently prepared, underscoring the need for targeted legal, ethical, and psychological support, alongside clear institutional guidelines. Strengthening institutional structures and national oversight mechanisms is essential to improve end-of-life care and ensure ethically consistent practices.
Organisation(en): Institut für Ethik und Recht in der Medizin, Institut für Klinische und Gesundheitspsychologie, Forschungs-, Lehr- und Praxisambulanz
Journal: Palliative Care and Social Practice
Publikationsdatum: 10-2025
Peer-reviewed: Ja
ÖFOS 2012: 505010 Medizinrecht, 303019 Medizinische Ethik, 302058 Palliativmedizin, 501021 Sozialpsychologie
Link zum Portal: https://ucrisportal.univie.ac.at/de/publications/b529cedd-c72a-4b37-a004-8a3e89cf0a6f