title: Expressed desire for hastened death in seven patients living with advanced cancer: a phenomenologic inquiry.
abstract: 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.
authors.affiliation: Pain and Palliative Care Service at Memorial Sloan-Kettering Cancer Center, New York, NY, USA. coylen@mskcc.org.
authors.forename: Nessa
authors.initials: N
authors.lastname: Coyle
authors.forename: Lois
authors.initials: L
authors.lastname: Sculco
mesh_terms: 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*