The clinical evaluation of the wish to hasten death is not upsetting for advanced cancer patients: A cross-sectional study

Palliat Med. 2019 Jun;33(6):570-577. doi: 10.1177/0269216318824526. Epub 2019 Jan 28.

Abstract

Background: An important concern of healthcare professionals when exploring the wish to hasten death with patients is the risk of causing them some type of distress.

Aim: To assess the opinion of hospitalized patients with advanced cancer about the proactive assessment of the wish to hasten death.

Design: Descriptive, cross-sectional study.

Setting/participants: We assessed 193 advanced cancer patients admitted to an oncology ward for the wish to hasten death using a semi-structured clinical interview. After the assessment the participants were surveyed to determine whether they found the interview upsetting and, if so to what extent, and also their opinion regarding the assessment's importance.

Results: The wish to hasten death was reported by 46 (23.8%) patients. The majority of patients (94.8%) did not find talking about the wish to hasten death to be upsetting, regardless of whether they presented it or not. The majority of patients (79.3%) considered that it was either quite or extremely important for the clinician to proactively assess the wish to hasten death and discuss this topic, regardless of whether they experienced it.

Conclusions: In this study, most of the advanced cancer patients did not find the assessment of wish to hasten death to be upsetting, and a substantial proportion of patients in this study believe that it is important to routinely evaluate it in this setting. These findings suggest that healthcare professionals can explore the wish to hasten death proactively in routine clinical practice without fear of upsetting patients.

Keywords: Wish to die; clinical interview; desire to die; neoplasms; palliative care; palliative medicine; patient reported outcome measures; suicidal ideation; wish to hasten death.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude to Death*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / psychology*
  • Socioeconomic Factors
  • Stress, Psychological*
  • Suicide, Assisted / psychology*
  • Surveys and Questionnaires
  • Terminally Ill / psychology*