Factors associated with the wish to hasten death: a study of patients with terminal illness

Kelly, Brian; Burnett, Paul C.; Pelusi, Dan; Badger, Shirlene; Varghese, F. T.; Robertson, Marguerite

doi:10.1017/s0033291702006827

Cited by 121 publications

(99 citation statements)

References 27 publications

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“…The DDRS has recently been modified by Kelly et al [71] with the aim of producing an instrument that is capable of assessing both the intensity of the desire for death and potentially related factors. The modified version of the scale (the WTHD scale) comprises six items that are scored on a five-point Likert scale.…”

Section: Epidemiology Of the Wthd And Instruments For Measuring Itmentioning

confidence: 99%

“…The modified version of the scale (the WTHD scale) comprises six items that are scored on a five-point Likert scale. In the study by Kelly et al [71], the scale was administered to a sample of 256 terminally ill patients in Australia and showed adequate validity and reliability. Prevalence data showed that 14% of patients reported a strong WTHD [71].…”

Section: Epidemiology Of the Wthd And Instruments For Measuring Itmentioning

confidence: 99%

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The wish to hasten death: a review of clinical studies

et al. 2010

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It is common for patients who are faced with physical or psychological suffering, particularly those in the advanced stages of a disease, to have some kind of wish to hasten death (WTHD). This paper reviews and summarises the current state of knowledge about the WTHD among people with end-stage disease, doing so from a clinical perspective and on the basis of published clinical research. Studies were identified through a search strategy applied to the main scientific databases.Clinical studies show that the WTHD has a multi-factor aetiology. The literature review suggests-perhaps in line with better management of physical pain-that psychological and spiritual aspects, including social factors, are the most important cause of such a wish. One of the difficulties facing clinical research is the lack of terminological and conceptual precision in defining the construct. Indeed, studies frequently blur the distinction between a generic wish to die, a WTDH (whether sporadic or persistent over time), the explicit expression of a wish to die, and a request for euthanasia or physician-assisted suicide.A notable contribution to knowledge in this field has been made by scales designed to evaluate the WTHD, although the problems of conceptual definition may once again limit the conclusions, which can be drawn from the results. Studies using qualitative methodology have also provided new information that can help in understanding such wishes.Further clinical research is needed to provide a complete understanding of this phenomenon and to foster the development of suitable care plans.

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Section: Epidemiology Of the Wthd And Instruments For Measuring Itmentioning

confidence: 99%

Section: Epidemiology Of the Wthd And Instruments For Measuring Itmentioning

confidence: 99%

The wish to hasten death: a review of clinical studies

et al. 2010

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“…17 Similar findings have been reported for other patients near death, including people with end-stage cancer, 18 AIDS, 19 ALS, 20,21 and those receiving hospice and in-home palliative care. 22 These studies suggest that one-fourth to one-half of patients consider seeking assistance in dying. In a study conducted before the introduction of antiretroviral medications, as many as 12% of an AIDS sample received increases in medications designed to end suffering that also hastened dying.…”

Section: Comparisons Between Patients Who Expressed a Wish To Die Butmentioning

confidence: 99%

Bilateral extraocular muscle metastasis from primary breast cancer

Peckham¹,

Giblen²,

Kim³

et al. 2005

Neurology

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Abstract-Background:In retrospective studies, estimates of hastened dying among seriously ill patients range from Ͻ2% in one national survey to as much as 20% in end-stage disease cohorts. Objective: To examine, in prospective studies, dying patients in the months before death, in order to understand the wish to die. Methods: Patients with advanced ALS with a high likelihood of death or need for tracheostomy within 6 months were identified. Patients were assessed monthly with an extensive psychosocial interview, including a diagnostic interview for depression. Family caregivers were interviewed on the same schedule and also after patient deaths. Results: Eighty patients with ALS were enrolled, 63% of eligible patients; 53 died over follow-up. Ten (18.9%) of the 53 expressed the wish to die, and 3 (5.7%) hastened dying. Patients expressing the wish to die did not differ in sociodemographic features, ALS severity, or perceived burden of family caregivers. They were more likely to meet criteria for depression, but differences were smaller when suicidality was excluded from the depression interview. Patients who expressed the wish to die reported less optimism, less comfort in religion, and greater hopelessness. Compared with patients unable to act on the wish to die, patients who hastened dying reported reduction in suffering and increased perception of control over the disease in the final weeks of life. Conclusion: These findings suggest caution in concluding that the desire to hasten dying in end-stage disease is simply a feature of depression.

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“…Fewer social supports (Breitbart, Rosenfeld & Passik, 1996;Kelly et al, 2003;Schroepfer, 2008), a lower quality of social support (Arnold, 2004;Breitbart et al, 1996;Chochinov et al, 1995;Emanuel, Fairclough, & Emanuel, 2000;Kelly et al, 2003), conflictual social support (Schroepfer, 2008), low satisfaction with social support (Breitbart et al, 2000), and a perceived absence of social support (O'Mahony et al, 2005) have been reported by terminally ill individuals and individuals with a terminal illness-all of whom had either hastened their death or considered doing so. Although these findings point to the importance of receiving quality social support in the dying process, it is not known whether the anticipation of future support plays a similar role.…”

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confidence: 99%