The Wish to Hasten Death in Patients With Life-Limiting Conditions. A Systematic Overview

Area of Science:

• Palliative Care
• Medical Ethics
• Psychology

Background:

• The wish to hasten death in life-limiting conditions has been previously reviewed, but new primary studies and reviews have since emerged.
• Existing literature has expanded understanding of the conceptual definition, causes, and assessment of this complex phenomenon.

Purpose of the Study:

• To synthesize current literature on the wish to hasten death in individuals with life-limiting conditions.
• To provide an updated overview of research findings, including conceptualizations, contributing factors, and assessment methods.

Main Methods:

• An integrative review methodology was employed, encompassing systematic reviews and primary studies.
• Searches were conducted across major databases (PubMed, CINAHL, Scopus, Web of Science) up to 2023.
• Included were all published systematic reviews and primary studies not previously incorporated into systematic reviews.

Main Results:

• Eleven systematic reviews and 35 primary studies were analyzed.
• The wish to hasten death is conceptualized as a continuum, from thoughts to action.
• Nine assessment tools exist; prevalence varies by instrument wording and cutoff. Key related factors include depression, pain, functional disability, lack of meaning, burden, and reduced quality of life.

Conclusions:

• The findings highlight the need for refined clinical strategies to identify diverse expressions of the wish to hasten death.
• Understanding the continuum and associated factors is crucial for effective patient care and support.