Desire to die in terminally ill people: a framework for assessment and intervention

"Desire-to-die" statements made by people with terminal illness may be expressions of depression, suicidal intent, or coping. Careful evaluation can help the social worker understand the meaning of a particular patient's statement. The framework presented in this article suggests that all patients expressing a wish for death be assessed for both depression and suicide risk. This assessment can identify those patients who are depressed or suicidal, as well as those using these statements as a way of coping or as an indication of a rational choice for suicide. Differentiating among patients' meanings in this way leads to appropriate interventions.