Citation

Comby MC, Filbet M. Int. J. Med. 2006; 8(1): 57-63.

Copyright

(Copyright © 2006, International Medical Publishing Group)

DOI

unavailable

PMID

unavailable

Abstract

OBJECTIVEs - To draw up an inventory of euthanasia requests, analyse their reasons and follow their development affect the patients have been admitted to a palliative care unit. Design and Method - A prospective survey of five palliative care units in the Rhône-Alpes region of France over a six-month period identified 13 requests for euthanasia (from the patient, family or both). Setting - Palliative care units in the Rhône-Alpes region of France.

RESULTS - The frequency of the request was low at 2.1% (of 611 patients). In the first case, the patient suffered from an adaptative disorder and had a very difficult relationship with the medical team (ambivalence, revenge, aggressiveness). The second case, whose tragic outcome was the suicide of the patient in hospital, was in a context of very severe physical symptoms not relieved by the treatment, of family difficulties and an acute depressive syndrome. In addition, the family agreed to the request and the patient was very aggressive towards the medical team. Thus, the suicide was a kind of revenge on the doctors, 'unable' to relieve the patient.

CONCLUSION - This study has shown that requests for euthanasia do occur in spite of palliative care. The cases are not frequent (about 1% of patients receiving palliative care in the units included in the survey), but they can raise management difficulties within medical teams and they call for an ethical questioning and a multidisciplinary reflection. The relatively new fact that appears in our survey is the importance of the patient's environmental factors in the emergence and persistence of a request for euthanasia: 'family' reasons (exhaustion, communication problems, conflicts), which up to now has not been studied much, were found in almost all requests. © International Medical Publishing Group.

Language: en

Keywords

adolescent; adult; human; suicide; female; male; prognosis; aged; family; depression; Euthanasia; France; disease severity; article; conflict; euthanasia; physician; behavior disorder; clinical article; hospital admission; environmental factor; palliative therapy; health survey; adaptive behavior; neurologic disease; prospective study; symptom; malignant neoplastic disease; Family exhaustion; Palliative care unit; Patients suffering