title: Origins of the desire for euthanasia and assisted suicide in people with HIV-1 or AIDS: a qualitative study.
abstract: BACKGROUND
  Euthanasia and assisted suicide, and policies to address them are the subjects of contentious debate in many countries. However, the question of why people desire euthanasia or assisted suicide has not been coherently answered. We aimed to answer this question in a specific group of patients.
  
  
  METHODS
  We did a qualitative study of 32 people with HIV-1 or AIDS, who were enrolled in the HIV-1 Ontario Observational Database at Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada. We elicited participants' experiences of deliberation about euthanasia or assisted suicide, and the meaning of these experiences with in-depth, face-to-face interviews. We analysed our data with grounded theory methods.
  
  
  RESULTS
  Participants' desire for euthanasia and assisted suicide were affected by two main factors: disintegration, which resulted from symptoms and loss of function; and loss of community, which we defined as progressive diminishment of opportunities to initiate and maintain close personal relationships. These factors resulted in perceived loss of self. Euthanasia and assisted suicide were seen by participants as means of limiting loss of self.
  
  
  CONCLUSIONS
  These determinants of desire for euthanasia or assisted suicide in people with HIV-1 or AIDS have implications for the debate on these practices, and development of policies to regulate them.
authors.affiliation: University of Toronto Joint Centre for Bioethics, Toronto, Ontario, Canada. laveryj@mail.nih.gov
authors.forename: J V
authors.initials: JV
authors.lastname: Lavery
authors.forename: J
authors.initials: J
authors.lastname: Boyle
authors.forename: B M
authors.initials: BM
authors.lastname: Dickens
authors.forename: H
authors.initials: H
authors.lastname: Maclean
authors.forename: P A
authors.initials: PA
authors.lastname: Singer
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology*; D000328:Adult; D001293:Attitude to Death; D016208:Databases, Factual; D003657:Decision Making; D005065:Euthanasia / Q000331:legislation & jurisprudence; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D015497:HIV-1; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008960:Models, Psychological; D009864:Ontario; D036301:Qualitative Research; D017236:Suicide, Assisted / Q000331:legislation & jurisprudence