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. 2016 Jan 4;11(1):e0146184.
doi: 10.1371/journal.pone.0146184. eCollection 2016.

An International Consensus Definition of the Wish to Hasten Death and Its Related Factors

Albert Balaguer  1 , Cristina Monforte-Royo  2 , Josep Porta-Sales  1   3 , Alberto Alonso-Babarro  4 , Rogelio Altisent  5 , Amor Aradilla-Herrero  6 , Mercedes Bellido-Pérez  2 , William Breitbart  7 , Carlos Centeno  8 , Miguel Angel Cuervo  9 , Luc Deliens  10 , Gerrit Frerich  11 , Chris Gastmans  12 , Stephanie Lichtenfeld  13 , Joaquín T Limonero  14 , Markus A Maier  13 , Lars Johan Materstvedt  15 , María Nabal  16 , Gary Rodin  17 , Barry Rosenfeld  18 , Tracy Schroepfer  19 , Joaquín Tomás-Sábado  6 , Jordi Trelis  3 , Christian Villavicencio-Chávez  1   3 , Raymond Voltz  11
Affiliations

An International Consensus Definition of the Wish to Hasten Death and Its Related Factors

Albert Balaguer et al. PLoS One. .

Erratum in

  • Correction: An International Consensus Definition of the Wish to Hasten Death and Its Related Factors.
    Balaguer A, Monforte-Royo C, Porta-Sales J, Alonso-Babarro A, Altisent R, Aradilla-Herrero A, Bellido-Pérez M, Breitbart W, Centeno C, Cuervo MA, Deliens L, Frerich G, Gastmans C, Lichtenfeld S, Limonero JT, Maier MA, Materstvedt LJ, Nabal M, Rodin G, Rosenfeld B, Schroepfer T, Tomás-Sábado J, Trelis J, Villavicencio-Chávez C, Voltz R. Balaguer A, et al. PLoS One. 2018 Apr 26;13(4):e0196754. doi: 10.1371/journal.pone.0196754. eCollection 2018. PLoS One. 2018. PMID: 29698520 Free PMC article.

Abstract

Background: The desire for hastened death or wish to hasten death (WTHD) that is experienced by some patients with advanced illness is a complex phenomenon for which no widely accepted definition exists. This lack of a common conceptualization hinders understanding and cooperation between clinicians and researchers. The aim of this study was to develop an internationally agreed definition of the WTHD.

Methods: Following an exhaustive literature review, a modified nominal group process and an international, modified Delphi process were carried out. The nominal group served to produce a preliminary definition that was then subjected to a Delphi process in which 24 experts from 19 institutions from Europe, Canada and the USA participated. Delphi responses and comments were analysed using a pre-established strategy.

Findings: All 24 experts completed the three rounds of the Delphi process, and all the proposed statements achieved at least 79% agreement. Key concepts in the final definition include the WTHD as a reaction to suffering, the fact that such a wish is not always expressed spontaneously, and the need to distinguish the WTHD from the acceptance of impending death or from a wish to die naturally, although preferably soon. The proposed definition also makes reference to possible factors related to the WTHD.

Conclusions: This international consensus definition of the WTHD should make it easier for clinicians and researchers to share their knowledge. This would foster an improved understanding of the phenomenon and help in developing strategies for early therapeutic intervention.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flowchart of the Delphi process.
See this image and copyright information in PMC

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