title: Desire for hastened death: how do professionals in specialized palliative care react?
abstract: OBJECTIVE
  Desires for hastened death (DHD; wish to hasten death is also in use) are prevalent in terminally ill patients. Studies show that health professionals (HP) are often underprepared when presented with DHD. HPs in specialized palliative care (SPC-HP) often encounter DHD. This study aimed to identify SPC-HP responses to DHD in daily practice and their corresponding functions.
  
  
  METHODS
  Narrative interviews were conducted with 19 SPC-HPs at four German University Hospitals. Transcripts were analyzed using the documentary method. An inventory of established responses to DHD was compiled, and their corresponding functions in the context of the patient-SPC-HP interaction were reconstructed.
  
  
  RESULTS
  Twelve response categories and six corresponding functions were identified. On the patient level, responses categorized as symptom control, exploring the reasons and generating perspective, reorientation, and hope were particularly used to ease the patient's burden. On the interaction level, creating a relationship was fundamental. On the SPC-HP level, various methods served the functions self-protection and showed professional expertise.
  
  
  CONCLUSIONS
  Profound personal and professional development is necessary to respond to the inherent challenges presented by DHD. Establishing helpful relationships with patients is essential regardless of SPC-HP specialization. SPC-HPs should maximize their skills in establishing and maintaining relationships as well as strengthening their own resilience, possibly in specific training courses.
authors.affiliation: Center for Palliative Medicine, University Hospital of Cologne, Köln, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Galushko
authors.affiliation: Center for Palliative Medicine, University Hospital of Cologne, Köln, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Frerich
authors.affiliation: Center for Palliative Medicine, University Hospital of Cologne, Köln, Germany.|Center for Integrated Oncology, (CIO), Köln/Bonn, Germany.
authors.forename: K M
authors.initials: KM
authors.lastname: Perrar
authors.affiliation: Center for Palliative Medicine, University Hospital of Cologne, Köln, Germany.|Center for Integrated Oncology, (CIO), Köln/Bonn, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Golla
authors.affiliation: Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany.|Palliative Care Center, Malteser Hospital Seliger Gerhard Bonn/Rhein-Sieg, Bonn, Germany.|Center for Integrated Oncology, (CIO), Köln/Bonn, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Radbruch
authors.affiliation: Departmentof Palliative Medicine, University Hospital, Göttingen, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Nauck
authors.affiliation: Division of Palliative Medicine & Comprehensive Cancer Center, CCC Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Ostgathe
authors.affiliation: Center for Palliative Medicine, University Hospital of Cologne, Köln, Germany.|Center for Integrated Oncology, (CIO), Köln/Bonn, Germany.|Clinical Trials Center Cologne, (ZKS), Köln, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Voltz
mesh_terms: D000328:Adult; D001293:Attitude to Death; D005065:Euthanasia / Q000523:psychology*; D006282:Health Personnel / Q000523:psychology*; D065026:Hope; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D033262:Narration; D010166:Palliative Care / Q000523:psychology*; D010817:Physician-Patient Relations; D017236:Suicide, Assisted / Q000523:psychology*; D019452:Terminally Ill / Q000523:psychology*