Background: In Switzerland, right-to-die organizations such as Exit Deutsche
Schweiz offer suicide assistance to their members. However, there is limited
knowledge of the impact that witnessing assisted suicide has on the post-
traumatic stress severity or the grief process of family members. Low
perceived social acknowledgement may affect mental health. Methods: A cross-
sectional survey of 85 family members who were present at an assisted suicide
was conducted in December 2007. The Inventory of Complicated Grief and the
Impact of Event Scale were used to assess symptoms of post-traumatic stress
disorder (PTSD) and complicated grief (CG) at 14 to 24 months post-loss.
Further, the Social Acknowledgement Questionnaire was used to examine the
impact that the social environment’s acknowledgement of the end-of-life
decision had on respondents’ mental health. Results: As expected, social
acknowledgement as a survivor was related to PTSD symptoms and CG. In
particular, perceived general disapproval was strongly correlated with all
outcome measures, whereas recognition was not significantly related to PTSD or
CG (intrusion and avoidance). Conclusion: Family members of patients who use
assisted suicide may hesitate to disclose the manner of death, and the
community and societal environment may express strong views concerning the
end-of-life decision. This can lead to increased levels of PTSD and CG
