These scales should, in theory, facilitate the quantification and comparison of the WTHD in different populations, although the construct they quantify is often too broad and imprecise. , or the instrument created by Rosenfeld et al. , which was subsequently modified by Kelly et al. Noteworthy in this regard has been the design of certain measurement instruments, such as the scale developed by Chochinov et al. Nevertheless, some studies have sought to provide data regarding its epidemiology and prevalence in different settings. In addition to this lack of consensus regarding the conceptual definition and terminology of the WTHD, another aspect to consider is that the phenomenon tends to vary over time, depending on the stage or circumstances in which patients find themselves, ,, , and this makes it enormously difficult to estimate its frequency. Thus, one finds the indistinct use of terms such as ‘wish to die’, ‘want to die’ or ‘desire to die’, , as well as ‘wish to hasten death’, , ‘desire for early death’ and other related expressions or synonyms for requests for euthanasia or assisted suicide, such as ‘death-hastening request’, ‘request to die’, ‘request for euthanasia’ and ‘request for physician-assisted suicide’. Indeed, studies have not distinguished clearly between a general wish to die, the wish to hasten death and requests for euthanasia or physician-assisted suicide.
#The meaning of hasten how to#
One of the difficulties faced by any clinical study of the WTHD is how to define the concept. family or community breakdown), may contribute to making the WTHD more common, ,. In this regard, medical advances that increase life expectancy and disease chronicity, as well as other social phenomena found in developed societies (e.g.
This phenomenon seems to affect a considerable number of patients, especially those facing the end of life or advanced stages of their illness. to cease living in this way and to put an end to suffering while maintaining some control over the situation.įor several decades now, clinicians and researchers have shown a growing interest in analysing the wish to hasten death (WTHD) in the context of serious or incurable illness. According to this model the factors that lead to the emergence of WTHD are total suffering, loss of self and fear, which together produce an overwhelming emotional distress that generates the WTHD as a way out, i.e. An explanatory model was developed which showed the WTHD to be a reactive phenomenon: a response to multidimensional suffering, rather than only one aspect of the despair that may accompany this suffering. Six main themes emerged giving meaning to the WTHD: WTHD in response to physical/psychological/spiritual suffering, loss of self, fear of dying, the desire to live but not in this way, WTHD as a way of ending suffering, and WTHD as a kind of control over one's life (‘having an ace up one's sleeve just in case’). The seven-stage Noblit and Hare approach was applied, using reciprocal translation and line-of-argument synthesis.
Finally, seven studies reporting the experiences of 155 patients were included. Studies were identified through six databases (ISI, PubMed, PsycINFO, CINAHL, CUIDEN and the Cochrane Register of Controlled Trials), together with citation searches and consultation with experts. Systematic review and meta-ethnography of qualitative studies from the patient's perspective.
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