Expressed desire for hastened death in seven patients living with advanced cancer: a phenomenologic inquiry

Abstract

Purpose/objectives: To explore the meanings and uses of an expressed desire for hastened death in seven patients living with advanced cancer.

Design: A phenomenologic inquiry.

Setting: Urban cancer research center.

Sample: 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.

Findings: 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.

Implications for nursing: Listening to the patient's story will help nurses understand what is being asked for through the expression of a desire for hastened death.