PT - JOURNAL ARTICLE AU - Anke Erdmann AU - Celia Spoden AU - Irene Hirschberg AU - Gerald Neitzke TI - The wish to die and hastening death in amyotrophic lateral sclerosis: A scoping review AID - 10.1136/bmjspcare-2020-002640 DP - 2021 Sep 01 TA - BMJ Supportive & Palliative Care PG - 271--287 VI - 11 IP - 3 4099 - http://spcare.bmj.com/content/11/3/271.short 4100 - http://spcare.bmj.com/content/11/3/271.full SO - BMJ Support Palliat Care2021 Sep 01; 11 AB - Background Amyotrophic lateral sclerosis (ALS) develops into a life-threatening condition 2 to 4 years after the onset of symptoms. Although many people with the disease decide in favour of life-sustaining measures, thoughts about hastening death are not uncommon.Objectives Our aim was to examine the scope of literature on the wish to die in ALS and provide an insight into determinants and motives for different end-of-life options.Methods We searched eight databases for English and German publications on death wishes in ALS for the period from 2008 to 2018 and updated the search up to May 2020. After the screening process, 213 full texts were included for the final analysis. We analysed the texts in MAXQDA, using deductively and inductively generated codes.Results We identified end-of-life considerations, ranging from wishes to die without hastening death, to options with the possibility or intention of hastening death. Besides physical impairment, especially psychosocial factors, socio-demographic status and socio-cultural context have a great impact on decisions for life-shortening options. There is huge variation in the motives and determinants for end-of-life considerations between individuals, different societies, healthcare and legal systems.Conclusions For a variety of reasons, the information and counselling provided on different options for sustaining life or hastening death is often incomplete and insufficient. Since the motives and determinants for the wish to hasten death are extremely diverse, healthcare professionals should investigate the reasons, meaning and strength of the desire to die to detect unmet needs and examine which interventions are appropriate in each individual case.