Desire for hastened death among patients with advanced AIDS.
The recent debate over legalization of physician-assisted suicide has fueled interest in understanding factors that lead medically ill patients to seek a hastened death. The authors investigated the prevalence and predictors of desire for hastened death in 372 patients with advanced AIDS who were newly admitted to a palliative-care facility. Clinician-rated and self-report measures of desire for hastened death, depression, hopelessness, spiritual well-being, social support, pain, and physical symptom burden were administered to assess the factors that correspond to a high desire for death. The prevalence ranged from 4.6% to 8.3%, significantly lower than in previous studies of patients with advanced or terminal cancer. Multivariate models revealed significant and unique effects for both hopelessness and depression, with these variables accounting for a large proportion of the variance in each model. Authors discuss the implications of these findings for palliative care practice and the assisted-suicide debate.
Rosenfeld
Barry
B
Department of Psychology, Fordham University, Bronx, NY 10458, USA. rosenfeld@fordham.edu
Breitbart
William
W
Gibson
Christopher
C
Kramer
Michael
M
Tomarken
Alexis
A
Nelson
Christian
C
Pessin
Hayley
H
Esch
Julie
J
Galietta
Michele
M
Garcia
Nerina
N
Brechtl
John
J
Schuster
Michael
M
D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology* / Q000628:therapy*; D000328:Adult; D000368:Aged; D001293:Attitude to Death; D003866:Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D033101:Euthanasia, Active, Voluntary; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D010166:Palliative Care; D011569:Psychiatric Status Rating Scales; D017236:Suicide, Assisted / Q000331:legislation & jurisprudence; D013727:Terminal Care; D019452:Terminally Ill / Q000523:psychology*