Experiences and Motivations Underlying Wishes to Die in Older People Who Are Tired of Living: A Research Area in its Infancy

2014 ◽  
Vol 69 (2) ◽  
pp. 191-216 ◽  
Author(s):  
Els van Wijngaarden ◽  
Carlo Leget ◽  
Anne Goossensen
Keyword(s):  
Older People ◽  
Assisted Suicide ◽  
Severe Depression ◽  
Personal Characteristics ◽  
Research Area ◽  
Physician Assisted Suicide ◽  
Age Related ◽  
Wish To Die ◽  
Life Threatening ◽  
Insight Into

The wish to die in older people who are tired of living and the possibilities to organize death are currently being discussed within the debate on self-determination and physician-assisted suicide. Until now insight into the experiences and thoughts of people who are tired of life but not suffering from a severe depression or a life-threatening disease is lacking. Studies focussing specifically on this topic are rare. This review provides an overview of this research area in its infancy. The existential impact of age-related loss experiences play an important role in developing a wish to die. Other influencing factors are: personal characteristics, biographical factors, social context, perceptions and values. Further research to experiences and motivations underlying these specific age-related wishes to die and the existential impact of the loss-experiences seems necessary to deepen the understanding of this group of older people and for the development of policy and good care.

scholarly journals Complexities in consultations in case of euthanasia or physician-assisted suicide: a survey among SCEN physicians

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Tessa D. Bergman ◽  
H. Roeline W. Pasman ◽  
Bregje D. Onwuteaka-Philipsen
Keyword(s):  
Psychiatric Disorders ◽  
Assisted Suicide ◽  
Public Debate ◽  
Main Diagnosis ◽  
Physician Assisted Suicide ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Age Related ◽  
Attending Physician ◽  
Complex Cases

Abstract Background In the Netherlands, euthanasia or physician-assisted suicide (EAS) is allowed if due care criteria are met. One criterion is consultation of a second independent physician, often SCEN physicians. The public debate about EAS focuses on patients with psychiatric disorders, dementia, and tired of living, as complex cases. What complexities SCEN physicians perceive during consultation is unknown. This study aims to assess the frequency of EAS consultations that are perceived difficult by SCEN physicians, to explore what complexities are perceived by SCEN physicians during consultation, and to assess what characteristics are associated with difficult consultations. Methods Data from 2015 to 2017 from an annual cross-sectional survey among SCEN physicians was used. In 2015, the survey focused on the most difficult consultation that year and in 2016/2017 on the most recent consultation. Frequencies of coded answers to an open-ended question were done to explore what complexities SCEN physicians perceived during their most difficult consultation. Univariable and multivariable logistic regression analyses were used to assess what characteristics were associated with difficult consultations. Results 21.6% of cases consulted by SCEN physicians is perceived difficult. Complexities that SCEN physicians perceive were mainly in contact with patients (79.7%) and in the assessment of due care criteria (41.0%). Characteristics that were associated with a higher likelihood of a consultation being difficult are the attending physician being less certain to perform the EAS, patients staying in the hospital, main diagnosis heart failure/CVA, and accumulation of age-related health problems/psychiatry/dementia, and the presence of a psychiatric disorder, or psychosocial or existential problems besides the main diagnosis. Characteristics that were associated with a lower likelihood of a consultation being difficult are high patient’s age and physical suffering as reason to request EAS. Conclusion Complexities perceived by SCEN physicians in EAS consultations are not limited to the ‘complex’ cases present in the current public debate about EAS, e.g. patients with psychiatric disorders, dementia, and tired of living. Attention for these complexities in intervision could indicate if there is a need among SCEN physicians to enhance knowledge and skills in training and to receive specific support in intervision on these complexities.

A “Suicide Pill” For Older People: Attitudes of Physicians, the General Population, and Relatives of Patients who died After Euthanasia or Physician-Assisted Suicide in The Netherlands

Death Studies ◽  
2005 ◽  
Vol 29 (6) ◽  
pp. 519-534 ◽  
Author(s):  
Mette L. Rurup ◽  
Bregje D. Onwuteaka-Philipsen ◽  
Gerrit van der Wal ◽  
Agnes van der Heide ◽  
Paul J. van Der Maas
Keyword(s):  
General Population ◽  
The Netherlands ◽  
Older People ◽  
Assisted Suicide ◽  
Physician Assisted Suicide

scholarly journals Er det at blive gammel tilstrækkelig årsag til dødshjælp?

2020 ◽  
pp. 235-247
Author(s):  
Søren Holm
Keyword(s):  
Mental Illness ◽  
Elderly People ◽  
Assisted Suicide ◽  
The Elderly ◽  
Assisted Dying ◽  
Physician Assisted Suicide ◽  
Wish To Die ◽  
The Right ◽  
The Relationship ◽  
Vulnerable Elderly

A proposal put forth in the Dutch Parliament suggests that anyone over the age of 75 should have a legally guaranteed right to physician-assisted suicide if they wish to die, unless the wish is the result of a mental illness. This chapter discusses three questions about the relationship between age and entitlement to assisted dying: 1) are there good reasons to introduce a purely age-determined criterion for a right to assisted dying; 2) would such an age criterion lead to problematic discrimination against the elderly, or alternatively to discrimination against people who are too young to meet the criterion; and 3) what is the relationship between an age criterion and a postulated duty to choose assisted dying in specific situations. The discussion of these three issues shows that there are no good reasons for introducing an age criterion for the right to die, that an age criterion is potentially discriminatory to both the elderly and the young, and that introducing an age criterion could lead to problematic pressure against vulnerable elderly people.

scholarly journals Palliative care for older people: the psychiatrist's role

2018 ◽  
Vol 25 (1) ◽  
pp. 37-46
Author(s):  
Victor M. Aziz ◽  
Rugiyya Saeed
Keyword(s):  
Older People ◽  
Assisted Suicide ◽  
Psychiatric Care ◽  
Learning Objectives ◽  
Personality Change ◽  
List Type ◽  
Physician Assisted Suicide ◽  
Individualised Care ◽  
Anxiety Depression

SUMMARYIn this overview we discuss the palliative psychiatric care of older people towards the end of life. We briefly consider ethics, dementia care, delirium, depression, anxiety, grief and physician-assisted suicide. We also discuss hope, dignity, spirituality and existentialism. We hope that this article will encourage clinicians to reflect on the effects of terminal illnesses on the mental health of dying people and the current provision of palliative psychiatric care.LEARNING OBJECTIVES•Appreciate that patient-centred care builds on providing individualised care for the dying person to meet their needs and wishes•Understand the collaborative role of psychiatry in assessing the aetiology and appropriate response to patients presenting with problems of loss, grief, anxiety, depression, hopelessness, suicidal ideation, personality change and confusion•Recognise that maintaining hope and living with hope is a way for terminally ill patients to endure and cope with their sufferingDECLARATION OF INTERESTNone.

Physician-Assisted Suicide and the Rise of Secularism

2017 ◽  
Vol 42 (5) ◽  
pp. 1-2
Author(s):  
Karen Wenger ◽  
Keyword(s):  
End Of Life ◽  
Assisted Suicide ◽  
Terminally Ill ◽  
Physician Assisted Suicide ◽  
Award Winning ◽  
Life Issues ◽  
Wish To Die ◽  
Aid In Dying ◽  
The Media ◽  
End Of Life Issues

The media has been instrumental in disseminating and glamorizing physician-assisted suicide, also known as aid in dying and medical aid in dying The organization Compassion and Choices claims that people seeking physician-assisted suicide want to live, carefully plan their demise, and often include family, while those who choose suicide are not terminally ill and wish to die, are typically impulsive in their decision, and act independently of family. The award-winning documentary How to Die in Oregon examines both sides of the debate and features several individuals as they struggle with end-of-life issues. The filmmakers help the viewer ponder important questions about the purported benefit of physician-assisted suicide.

scholarly journals What makes euthanasia justifiable

2019 ◽  
Author(s):  
Štěpán Bahník ◽  
Marek Vranka ◽  
Klára Trefná
Keyword(s):  
Assisted Suicide ◽  
Negative Impact ◽  
Personal Characteristics ◽  
Physician Assisted Suicide ◽  
Policy Decisions ◽  
Physical Suffering

The consideration of laypeople’s views of conditions under which euthanasia is justifiable is important for policy decisions. We examined how patient’s symptoms influence justifiability of euthanasia. Euthanasia was judged more justifiable for conditions associated with physical suffering and negative impact on other people. The weight given to physical suffering and negative impact on others in evaluation of justifiability of euthanasia also differed based on personal characteristics. The results suggest that legalization of euthanasia and physician-assisted suicide might have higher support if it is limited to specific patients’ conditions.

Understanding Why Older People Develop a Wish to Die

Crisis ◽  
2011 ◽  
Vol 32 (4) ◽  
pp. 204-216 ◽  
Author(s):  
M. L. Rurup ◽  
H. R. W. Pasman ◽  
J. Goedhart ◽  
D. J. H. Deeg ◽  
A. J. F. M. Kerkhof ◽  
...  
Keyword(s):  
Older People ◽  
Cohort Studies ◽  
Conceptual Framework ◽  
Life Events ◽  
Traumatic Life Events ◽  
Quantitative Studies ◽  
Wish To Die ◽  
Open Coding ◽  
Death Wishes ◽  
Depth Interviews

Background: Quantitative studies in several European countries showed that 10–20% of older people have or have had a wish to die. Aims: To improve our understanding of why some older people develop a wish to die. Methods: In-depth interviews with people with a wish to die (n = 31) were carried out. Through open coding and inductive analysis, we developed a conceptual framework to describe the development of death wishes. Respondents were selected from two cohort studies. Results: The wish to die had either been triggered suddenly after traumatic life events or had developed gradually after a life full of adversity, as a consequence of aging or illness, or after recurring depression. The respondents were in a situation they considered unacceptable, yet they felt they had no control to change their situation and thus progressively “gave up” trying. Recurring themes included being widowed, feeling lonely, being a victim, being dependent, and wanting to be useful. Developing thoughts about death as a positive thing or a release from problems seemed to them like a way to reclaim control. Conclusions: People who wish to die originally develop thoughts about death as a positive solution to life events or to an adverse situation, and eventually reach a balance of the wish to live and to die.

Euthanasia and Related Practices Worldwide

Crisis ◽  
1998 ◽  
Vol 19 (3) ◽  
pp. 109-115 ◽  
Author(s):  
Michael J Kelleher † ◽  
Derek Chambers ◽  
Paul Corcoran ◽  
Helen S Keeley ◽  
Eileen Williamson
Keyword(s):  
Assisted Suicide ◽  
International Association ◽  
Active Euthanasia ◽  
Physician Assisted Suicide ◽  
Passive Euthanasia ◽  
Medical Practitioners ◽  
General Acceptance ◽  
International Importance ◽  
Controversial Area ◽  
Active And Passive Euthanasia

The present paper examines the occurrence of matters relating to the ending of life, including active euthanasia, which is, technically speaking, illegal worldwide. Interest in this most controversial area is drawn from many varied sources, from legal and medical practitioners to religious and moral ethicists. In some countries, public interest has been mobilized into organizations that attempt to influence legislation relating to euthanasia. Despite the obvious international importance of euthanasia, very little is known about the extent of its practice, whether passive or active, voluntary or involuntary. This examination is based on questionnaires completed by 49 national representatives of the International Association for Suicide Prevention (IASP), dealing with legal and religious aspects of euthanasia and physician-assisted suicide, as well as suicide. A dichotomy between the law and medical practices relating to the end of life was uncovered by the results of the survey. In 12 of the 49 countries active euthanasia is said to occur while a general acceptance of passive euthanasia was reported to be widespread. Clearly, definition is crucial in making the distinction between active and passive euthanasia; otherwise, the entire concept may become distorted, and legal acceptance may become more widespread with the effect of broadening the category of individuals to whom euthanasia becomes an available option. The “slippery slope” argument is briefly considered.

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