Suicidal ideation at end-of-life: the palliative care team's role

To report on the case of a terminally ill patient who expresses suicidal ideation.

As this case demonstrates, suicidality at end-of-life poses numerous challenges for the palliative care team. In this case, a 49-year-old man with locally extensive head and neck cancer refused all life-prolonging treatment and expressed a desire to hasten his own death. Other issues, such as chemical dependency and lack of social supports, complicated his care.

Suicidality lessened as continuity of care, with ongoing assessments and interventions, addressed sources of suffering and built relationships with health care professionals.

This case highlights the observation that desire for hastened death fluctuates for patients at end-of-life and may be influenced by factors under the control of the palliative care team.