Terminally ill patients’ wish to die
The attitudes and concerns of patients with incurable cancer about the end of life and dying
This exploratory interview-based study investigates the subjective understanding, in particular the diachronic and relational characteristics of a wish to die in terminally ill cancer patients with short life expectancy in Switzerland. It investigates the phenomenon of a wish to die in the context of the subjective experiences of an incurable fatal oncological condition and of the situation of being on a way to death. A wish to die can have different meanings for the patient, depending on a wide range of factors in the context of their life histories. The differences in meaning might have an impact for the decisions in best end-of-life care.
The study aims to explore the phenomenon of a wish to die, i.e. the content and dynamics of factors associated with a wish to die in patients
- who wish to die but who do not wish to interfere in the course of illness in comparison to patients,
- who explicitly express a wish to hasten death with either passive or active measures,
- and with patients who are confronted with the situation to be near death without an explicit wish to die.
The perspectives, attitudes and concerns of patients in end-of-life care, including their ethical concerns and thinking shall be studied with an interpretative phenomenological approach on the basis of 30 patient case studies involving ca. 165 qualitative interviews with the patients, their medical team and their relatives. This method allows to study the ethical perspectives on the near death of a patient from different involved actors: the patient her- or himself, those responsible for medical care and nursing, and those affected by the expected loss of a relative. The work plan is based on a previous pilot study (otherwise financed), where the methodology has been established.
Results will help to improve end-of-life care decision-making and will inform the ethics of end-of-life care of cancer patients and palliative medicine.