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

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 desire to die wish to hasten death patient reported outcome measures neoplasms palliative care palliative medicine suicidal ideation clinical interview

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