Why do we want the right to die? A systematic review of the international literature on the views of patients, carers and the public on assisted dying

Abstract

Our review sheds light on ordinary people's perspectives about assisted dying, when they are ill or disabled. Unbearable suffering is a key construct, and common factors are revealed that lead people to ask for help to die. The consistency of international views indicates a mandate for legislative and medical systems worldwide to listen and understand this.

Assisted Suicide as a Remedy for Suffering? The End-of-Life Preferences of British “Suicide Tourists”

“…This was highlighted in the case of Sheila, whose desire to die was only partly attributable to her underlying medical condition but also undoubtedly influenced by her relationships, past and present. This finding is confirmed by other studies examining the motivations of people requesting an assisted suicide (Dees et al 2011;Hendry et al 2013). A primary question in the debate about whether assisted suicide should be legalized in the United Kingdom and elsewhere is where the limits of medicine lie in terms of the medical profession's responsibility to relieve suffering, given its phenomenological and intersubjective dimensions.…”

“…These four domains bear similarity to the four dimensions of 'total pain' (physical, mental, social, and spiritual), a concept central to the development of the modern hospice movement (Saunders 2006). The literature suggests that while those who request an assisted suicide are suffering from symptoms of illness or ageing, other factors influencing their quality of life can be important in motivating their desire to die (Hendry et al 2013). These factors include dependency on others; hopelessness; loss of 'self,' meaning or dignity; loneliness or loss of social connectedness; and being tired of life (Hendry et al 2013).…”

“…The literature suggests that while those who request an assisted suicide are suffering from symptoms of illness or ageing, other factors influencing their quality of life can be important in motivating their desire to die (Hendry et al 2013). These factors include dependency on others; hopelessness; loss of 'self,' meaning or dignity; loneliness or loss of social connectedness; and being tired of life (Hendry et al 2013). Although the existing literature acknowledges the "profoundly personal perception" of suffering and the huge diversity of motivations (63 separate motivations counted in Dees et al 2010:342), there is still a tendency to try to develop a typology of suffering and to quantify the incidence of each 'type' (Dees et al 2011).…”

Assisted dying in dementia: a systematic review of the international literature on the attitudes of health professionals, patients, carers and the public, and the factors associated with these

“…However, few studies have investigated the factors associated with attitudes towards assisted dying in dementia. The reviewed research consistently indicated an association between age, ethnicity, gender and religion and support for assisted dying in dementia, which is comparable with previous reviews on general assisted dying attitudes (Emanuel, 2002;Hendry et al, 2013). Interestingly, however, this review suggests that aside from religion, these sociodemographic factors are not significantly associated with physician's attitudes and are most frequently linked to public attitudes.…”

“…Previous systematic reviews have examined general attitudes towards assisted dying and have not specifically reviewed the literature in relation to dementia (Emanuel, 2002;McCormack et al, 2012;Hendry et al, 2013). However, people may hold different attitudes on assisted dying for degenerative diseases, compared with other terminal illnesses (Mitchell, 2004).…”