Expressed desire for hastened death in seven patients living with advanced cancer: a phenomenologic inquiry.
OBJECTIVE
To explore the meanings and uses of an expressed desire for hastened death in seven patients living with advanced cancer.


METHODS
A phenomenologic inquiry.


METHODS
Urban cancer research center.


METHODS
Terminally ill patients with cancer who had expressed a desire for hastened death.


METHODS
A series of in-depth semistructured interviews were audiotaped, transcribed, coded, and organized into themes.


RESULTS
The expression of desire for hastened death had many meanings and uses and communicated the following: (a) a manifestation of the will to live, (b) a dying process so difficult that an early death was preferred, (c) an intolerable immediate situation, even if not specifically identified by a patient, required immediate action, (d) a hastened death could extract a patient from an unendurable and specific situation, (e) manifestation of the last control the dying can exert, (f) a way of drawing attention to "me as a unique individual," (g) a gesture of altruism, (h) an attempt at manipulation of the family to avoid abandonment, and (i) a despairing cry depicting the misery of the current situation.


CONCLUSIONS
Expression of desire for hastened death has many meanings and uses and is a tool of communication.


CONCLUSIONS
Listening to the patient's story will help nurses understand what is being asked for through the expression of a desire for hastened death.
Coyle
Nessa
N
Pain and Palliative Care Service at Memorial Sloan-Kettering Cancer Center, New York, NY, USA. coylen@mskcc.org.
Sculco
Lois
L
D000328:Adult; D000368:Aged; D000533:Altruism; D001293:Attitude to Death; D002173:Cancer Care Facilities; D003073:Cognitive Dissonance; D004644:Emotions; D033101:Euthanasia, Active, Voluntary / Q000523:psychology*; D005239:Fear; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008257:Machiavellianism; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing / Q000473:pathology / Q000523:psychology*; D009723:Nurse-Patient Relations; D010146:Pain / Q000523:psychology; D026684:Personal Autonomy; D017236:Suicide, Assisted / Q000523:psychology*; D019452:Terminally Ill / Q000523:psychology*