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Desire for hastened death

William Breitbart, Hayley Pessin, Barry Rosenfeld, Allison J Applebaum, Wendy G Lichtenthal, Yuelin Li, Rebecca M Saracino, Allison M Marziliano, Melissa Masterson, Kristen Tobias, Natalie Fenn
BACKGROUND: Patients with advanced cancer have high rates of psychological distress, including depression, anxiety, and spiritual despair. This study examined the effectiveness of individual meaning-centered psychotherapy (IMCP) in comparison with supportive psychotherapy (SP) and enhanced usual care (EUC) in improving spiritual well-being and quality of life and reducing psychological distress in patients with advanced cancer. METHODS: Patients (n = 321) were randomly assigned to IMCP (n = 109), SP (n = 108), or EUC (n = 104)...
May 14, 2018: Cancer
Carla I Ripamonti, Federico Giuntoli, Silvia Gonella, Guido Miccinesi
PURPOSE OF REVIEW: Because of cancer is generally perceived as a life-threatening illness, patients often develop spiritual needs upon the diagnosis. Spirituality impacts patient quality of life (QoL) and provides a context in which to derive hope and meaning to cope with illness. The goal of this review is to give an overview of the most relevant studies with a focus on the relationship between spiritual well being, QoL and hope in patients with cancer, in addition to exploring the importance of spiritual issues both for patients and healthcare professionals...
May 8, 2018: Current Opinion in Oncology
Tara C Malone, Sarah E Mennenga, Jeffrey Guss, Samantha K Podrebarac, Lindsey T Owens, Anthony P Bossis, Alexander B Belser, Gabrielle Agin-Liebes, Michael P Bogenschutz, Stephen Ross
A growing body of evidence shows that existential and spiritual well-being in cancer patients is associated with better medical outcomes, improved quality of life, and serves as a buffer against depression, hopelessness, and desire for hastened death. Historical and recent research suggests a role for psilocybin-assisted psychotherapy in treating cancer-related anxiety and depression. A double-blind controlled trial was performed, where 29 patients with cancer-related anxiety and depression were randomly assigned to treatment with single-dose psilocybin (0...
2018: Frontiers in Pharmacology
Andrea Rodríguez-Prat, Cristina Monforte-Royo, Albert Balaguer
Some persons with advanced disease but no significant cognitive impairments consciously decide to stop taking food and fluids orally, even though they remain physically able to do so. The question is to what extent voluntarily stopping eating and drinking (VSED) may be considered an expression of a wish to hasten death, in the sense that the latter has been defined recently. We analyze the data reported in some studies in relation to primary care patients who died as a result of VSED and examine their results in light of the qualitative findings of patients that expressed a wish to die...
2018: Frontiers in Pharmacology
Mercedes Bellido-Pérez, Iris Crespo, Keith G Wilson, Josep Porta-Sales, Albert Balaguer, Cristina Monforte-Royo
INTRODUCTION: The Desire for Death Rating Scale (DDRS) and the short form of the Schedule of Attitudes toward Hastened Death (SAHD-5) are different approaches to assessing the wish to hasten death (WTHD). Both have clinical threshold scores for identifying individuals with a meaningfully elevated WTHD. However, the agreement between the 2 measures and patient opinions about assessment of the WTHD are unknown. OBJECTIVES: To compare the DDRS and SAHD-5 and to analyze patient opinions about assessment of the WTHD...
February 28, 2018: Psycho-oncology
Barry Rosenfeld, Heining Cham, Hayley Pessin, William Breitbart
OBJECTIVES: Meaning-Centered Group Psychotherapy (MCGP) has been demonstrated to be an effective method for improving advanced cancer patients' quality of life and reducing their depression, hopelessness, and desire for hastened death. To further understand MCGP, this study examined the mechanisms of change in MCGP on these outcomes via advanced cancer patients' changes of sense of meaning and peace in life. METHODS: The sample data were from 2 randomized control trials that compared MCGP (n = 124) to supportive group psychotherapy (n = 94)...
February 2018: Psycho-oncology
J G H Mulder, J P C Sonneveld
Patients considering physician-hastened death (PHD) increasingly express a wish to donate organs after death. This fairly unique proposition stems from patients' desire to do something good with (parts of) the same diseased body that has prompted them to request physician-hastened death. In this article we describe a patient with amyotrophic lateral sclerosis (ALS) who expressed this wish. In March 2017 a national guideline on 'Organ donation following physician-hastened death' (ODP) was presented to the Minister of Health, Welfare and Sport of the Netherlands...
2017: Nederlands Tijdschrift Voor Geneeskunde
Patricia S Coffey, Siobhan C Brown
BACKGROUND: Neonatal sepsis is the third leading cause of deaths for infants in their first month of life. The newly cut umbilical cord can be a pathway for bacteria that can cause newborn sepsis and death. Optimal umbilical cord care practices for newborns and during the first week of life, especially in settings with poor hygiene, has the potential to avoid these preventable neonatal deaths. The purpose of this review of cord care practices is to assist in the development of behavior-change strategies to support introduction of novel cord-care regimens, particularly 7...
February 20, 2017: BMC Pregnancy and Childbirth
Mercedes Bellido-Pérez, Cristina Monforte-Royo, Joaquín Tomás-Sábado, Josep Porta-Sales, Albert Balaguer
BACKGROUND: Patients with advanced conditions may present a wish to hasten death. Assessing this wish is complex due to the nature of the phenomenon and the difficulty of conceptualising it. AIM: To identify and analyse existing instruments for assessing the wish to hasten death and to rate their reported psychometric properties. DESIGN: Systematic review based on PRISMA guidelines. The COnsensus-based Standards for the selection of health Measurement INstruments checklist was used to evaluate the methodological quality of validation studies and the measurement properties of the instrument described...
June 2017: Palliative Medicine
Mark Corbett
Conceivably, in an ideal world, all patients with a life-limiting illness would receive optimal hospice and palliative care so that no one would ever wish to hasten their own death. The reality, however, is that despite provision of optimal hospice and palliative care, individuals with terminal illness experience suffering, loss of meaning, or deterioration in quality of life to the extent where they express the desire to expedite the dying process. While there has been extensive discussion surrounding physician-assisted death (PAD), there has been less attention paid to the practice of voluntary stopping eating and drinking (VSED) near the end of life...
2016: Narrative Inquiry in Bioethics
Sophie Robinson, David W Kissane, Joanne Brooker, Courtney Hempton, Susan Burney
CONTEXT: The risk of suicide is elevated in palliative care patients compared with the general population. Various psychological factors, including depression, demoralization, loss of control, and low self-worth, have been associated with a desire to hasten death. OBJECTIVES: The aim of this study was to investigate whether depression, demoralization, loss of control, and low self-worth mediated the relationship between global quality of life and desire to hasten death...
February 2017: Journal of Pain and Symptom Management
Elissa Kolva, Barry Rosenfeld, Ying Liu, Hayley Pessin, William Breitbart
Desire for hastened death (DHD) represents a wish to die sooner than might occur by natural disease progression. Efficient and accurate assessment of DHD is vital for clinicians providing care to terminally ill patients. The Schedule of Attitudes Toward Hastened Death (SAHD) is a commonly used self-report measure of DHD. The goal of this study was to use methods grounded in item response theory (IRT) to analyze the psychometric properties of the SAHD and identify an abbreviated version of the scale. Data were drawn from 4 studies of psychological distress at the end of life...
March 2017: Psychological Assessment
Ramona L Rhodes, Bryan Elwood, Simon C Lee, Jasmin A Tiro, Ethan A Halm, Celette S Skinner
BACKGROUND: Studies have identified racial differences in advance care planning and use of hospice for care at the end of life. Multiple reasons for underuse among African American patients and their families have been proposed and deserve further exploration. OBJECTIVE: The goal of this study was to examine perceptions of advance care planning, palliative care, and hospice among a diverse sample of African Americans with varying degrees of personal and professional experience with end-of-life care and use these responses to inform a culturally sensitive intervention to promote awareness of these options...
July 2017: American Journal of Hospice & Palliative Care
Gwenaëlle Bidet, Lysanne Daoust, Michel Duval, Thierry Ducruet, Baruch Toledano, Nago Humbert, France Gauvin
BACKGROUND: An order protocol for distress (OPD), including respiratory distress and acute pain crisis, has been established for pediatric palliative care patients at Sainte-Justine Hospital (SJH). After discussion with the patient/his or her family, the OPD is prescribed by the attending physician whenever judged appropriate. The OPD can then be initiated by the bedside nurse when necessary; the physician is notified after the first dose is administered. OBJECTIVES: The study objectives were to evaluate the perceptions and experience of the medical/nursing staff towards the use of the OPD...
March 2016: Journal of Palliative Medicine
Albert Balaguer, Cristina Monforte-Royo, Josep Porta-Sales, Alberto Alonso-Babarro, Rogelio Altisent, Amor Aradilla-Herrero, Mercedes Bellido-Pérez, William Breitbart, Carlos Centeno, Miguel Angel Cuervo, Luc Deliens, Gerrit Frerich, Chris Gastmans, Stephanie Lichtenfeld, Joaquín T Limonero, Markus A Maier, Lars Johan Materstvedt, María Nabal, Gary Rodin, Barry Rosenfeld, Tracy Schroepfer, Joaquín Tomás-Sábado, Jordi Trelis, Christian Villavicencio-Chávez, Raymond Voltz
BACKGROUND: The desire for hastened death or wish to hasten death (WTHD) that is experienced by some patients with advanced illness is a complex phenomenon for which no widely accepted definition exists. This lack of a common conceptualization hinders understanding and cooperation between clinicians and researchers. The aim of this study was to develop an internationally agreed definition of the WTHD. METHODS: Following an exhaustive literature review, a modified nominal group process and an international, modified Delphi process were carried out...
2016: PloS One
M Á Cuervo Pinna, M Rubio, R Altisent Trota, J Rocafort Gil, M Gómez Sancho
BACKGROUND AND OBJECTIVES: The decriminalisation of euthanasia and assisted medical suicide has generated a continuous debate. The terminological confusion is one of the main difficulties in obtaining medical practice consensus. The objective of this study was to determine whether the terms of Euthanasia and physician assisted suicide are used with the same meaning by doctors in Extremadura (Spain). MATERIAL AND METHOD: A qualitative study was conducted using two focus groups in which doctors from different specialties who attended a large number of terminal patients participated...
January 2016: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
Yin-Chih Wang, Chia-Chin Lin
BACKGROUND: Spirituality is a central component of the well-being of terminally ill cancer patients. OBJECTIVE: The aim of this study was to examine the mediating or moderating role of spiritual well-being in reducing the impact of cancer-related symptoms on quality of life and the desire for hastened death in terminally ill cancer patients. METHODS: Eighty-five terminally ill cancer patients were assessed using the Taiwanese version of the M...
July 2016: Cancer Nursing
M Galushko, G Frerich, K M Perrar, H Golla, L Radbruch, F Nauck, C Ostgathe, R Voltz
OBJECTIVE: Desires for hastened death (DHD; wish to hasten death is also in use) are prevalent in terminally ill patients. Studies show that health professionals (HP) are often underprepared when presented with DHD. HPs in specialized palliative care (SPC-HP) often encounter DHD. This study aimed to identify SPC-HP responses to DHD in daily practice and their corresponding functions. METHODS: Narrative interviews were conducted with 19 SPC-HPs at four German University Hospitals...
May 2016: Psycho-oncology
Elaine M Beller, Mieke L van Driel, Leanne McGregor, Shani Truong, Geoffrey Mitchell
BACKGROUND: Terminally ill people experience a variety of symptoms in the last hours and days of life, including delirium, agitation, anxiety, terminal restlessness, dyspnoea, pain, vomiting, and psychological and physical distress. In the terminal phase of life, these symptoms may become refractory, and unable to be controlled by supportive and palliative therapies specifically targeted to these symptoms. Palliative sedation therapy is one potential solution to providing relief from these refractory symptoms...
January 2, 2015: Cochrane Database of Systematic Reviews
Kathy Black, Ellen L Csikai
Due to the unprecedented increase in the United States aging demographics, many more people are living longer and reaching older ages than ever before. However, a longer life is not necessarily a better life, as the vast majority will face a period of prolonged deteriorating health prior to death. Although notable efforts have been underway that are designed to improve the end-of-life experience, increasing numbers of individuals express a desire and/or act upon an intent to end their lives precipitously. Though still limited, the options to actively participate in their own deaths are growing...
2015: Journal of Social Work in End-of-life & Palliative Care
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