Understanding patients’ experiences of the wish to hasten death: an updated and expanded systematic review and meta-ethnography

Abstract

ObjectivesPatients with advanced disease sometimes express a wish to hasten death (WTHD). In 2012, we published a systematic review and meta-ethnography of qualitative studies examining the experience and meaning of this phenomenon. Since then, new studies eligible for inclusion have been reported, including in Europe, a region not previously featured, and specifically in countries with different legal frameworks for euthanasia and assisted suicide. The aim of the present study was to update our previous review by including new research and to conduct a new analysis of available data on this topic.SettingEligible studies originated from Australia, Canada, China, Germany, The Netherlands, Switzerland, Thailand and USA.ParticipantsStudies of patients with life-threatening conditions that had expressed the WTHD.DesignThe search strategy combined subject terms with free-text searching of PubMed MEDLINE, Web of Science, CINAHL and PsycInfo. The qualitative synthesis followed the methodology described by Noblit and Hare, using the ‘adding to and revising the original’ model for updating a meta-ethnography, proposed by France et al. Quality assessment was done using the Critical Appraisal Skills Programme checklist.Results14 studies involving 255 participants with life-threatening illnesses were identified. Five themes emerged from the analysis: suffering (overarching theme), reasons for and meanings and functions of the WTHD and the experience of a timeline towards dying and death. In the context of advanced disease, the WTHD emerges as a reaction to physical, psychological, social and existential suffering, all of which impacts on the patient’s sense of self, of dignity and meaning in life.ConclusionsThe WTHD can hold different meanings for each individual—serving functions other than to communicate a genuine wish to die. Understanding the reasons for, and meanings and functions of, the WTHD is crucial for drawing up and implementing care plans to meet the needs of individual patients.

Nursing Professionals’ Attitudes, Strategies, and Care Practices Towards Death: A Systematic Review of Qualitative Studies

“…Other reviews have also been published focusing on specific aspects of the subject matter, such as the perceptions of death among critical care nurses who have cared for patients and families during life support withdrawal (Vanderspank‐Wright, Efstathiou, & Vandyk, 2018). Furthermore, reviews have been conducted with other populations, such as relatives (Wallace, Adorno, & Stewart, 2018) and patients (Monforte‐Royo, Villavicencio‐Chávez, Tomás‐Sábado, Mahtani‐Chugani, & Balaguer, 2012; Rodríguez‐Prat, Balanguer, Booth, & Monforte‐Royo, 2017).…”

The borderline between life and death

“…It is important to bear in mind that the patients’ perceptions of dignity are associated with both clinically and culturally competent care, suggesting nurses must not only understand their patients from the standpoint of symptoms, diagnosis and treatment, but should also understand the context of their experiences and culture (Asmaningrum & Tsai, ). Thus, MHPs need to strive to understand the reasons for as well as the meanings and functions of the suicidal wish in order to make and implement healthcare plans to meet the needs of individual patients (Rodríguez‐Prat, Balaguer, Booth, & Monforte‐Royo, ).…”

Demande de sédation continue jusqu’au décès : la place des soins psychiques

“…Les données issues des recherches sur ce désir de hâter la mort [11] doivent être prises en compte pour les raisons suivantes :…”