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

Published online by Cambridge University Press:  23 December 2002

B. KELLY
Affiliation:
Department of Psychiatry and Office of Public Policy and Ethics, University of Queensland and Centre for Palliative Care, Research and Education, Queensland University of Technology, Brisbane, Division of Mental Health, Princess Alexandra Hospital, Woolloongabba and Mt Olivet Hospital and Health Services, Kangaroo Point, Queensland; and Charles Sturt University, Wagga Wagga, New South Wales, Australia
P. BURNETT
Affiliation:
Department of Psychiatry and Office of Public Policy and Ethics, University of Queensland and Centre for Palliative Care, Research and Education, Queensland University of Technology, Brisbane, Division of Mental Health, Princess Alexandra Hospital, Woolloongabba and Mt Olivet Hospital and Health Services, Kangaroo Point, Queensland; and Charles Sturt University, Wagga Wagga, New South Wales, Australia
D. PELUSI
Affiliation:
Department of Psychiatry and Office of Public Policy and Ethics, University of Queensland and Centre for Palliative Care, Research and Education, Queensland University of Technology, Brisbane, Division of Mental Health, Princess Alexandra Hospital, Woolloongabba and Mt Olivet Hospital and Health Services, Kangaroo Point, Queensland; and Charles Sturt University, Wagga Wagga, New South Wales, Australia
S. BADGER
Affiliation:
Department of Psychiatry and Office of Public Policy and Ethics, University of Queensland and Centre for Palliative Care, Research and Education, Queensland University of Technology, Brisbane, Division of Mental Health, Princess Alexandra Hospital, Woolloongabba and Mt Olivet Hospital and Health Services, Kangaroo Point, Queensland; and Charles Sturt University, Wagga Wagga, New South Wales, Australia
F. VARGHESE
Affiliation:
Department of Psychiatry and Office of Public Policy and Ethics, University of Queensland and Centre for Palliative Care, Research and Education, Queensland University of Technology, Brisbane, Division of Mental Health, Princess Alexandra Hospital, Woolloongabba and Mt Olivet Hospital and Health Services, Kangaroo Point, Queensland; and Charles Sturt University, Wagga Wagga, New South Wales, Australia
M. ROBERTSON
Affiliation:
Department of Psychiatry and Office of Public Policy and Ethics, University of Queensland and Centre for Palliative Care, Research and Education, Queensland University of Technology, Brisbane, Division of Mental Health, Princess Alexandra Hospital, Woolloongabba and Mt Olivet Hospital and Health Services, Kangaroo Point, Queensland; and Charles Sturt University, Wagga Wagga, New South Wales, Australia

Abstract

Background. There is considerable debate regarding the clinical issues surrounding the wish to hasten death (WTHD) in the terminally ill. The clinical factors contributing to the WTHD need further investigation among the terminally ill in order to enhance understanding of the clinical assessment and treatment needs that underlie this problem. A more detailed understanding may assist with the development of appropriate therapeutic interventions.

Method. A sample of terminally ill cancer patients (N=256) recruited from an in-patient hospice unit, home palliative care service and a general hospital palliative care consulting service from Brisbane Australia between 1998–2001 completed a questionnaire assessing psychological (depression and anxiety), social (family relationship, social support, level of burden on others) and the impact of physical symptoms. The association between these factors and the WTHD was investigated.

Results. A high WTHD was reported by 14% of patients. A discriminant function analysis revealed that the following variables were associated with a high WTHD (P<0·001): higher levels of depressive symptoms, being admitted to an in-patient hospice setting, a greater perception of being a burden on others, lower family cohesion, lower levels of social support, higher levels of anxiety and greater impact of physical symptoms.

Conclusions. Psychological and social factors are related to a WTHD among terminally ill cancer patients. Greater attention needs to be paid to the assessment of psychological and social issues in order to provide appropriate therapeutic interventions for terminally ill patients.

Type
Research Article
Copyright
© 2003 Cambridge University Press

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