Citation

Weixler D, Marosi C, Koisser K, Masel EK. Tagliche Praxis 2021; 65(1): 149-158.

Copyright

(Copyright © 2021)

DOI

unavailable

PMID

unavailable

Abstract

In people with advanced life-limiting illnesses, a wish to die (WTD) often occurs and is only partially communicated openly. If a WTD is expressed, people in the close social environment are primarily addressed. For healthcare professionals, it is important to know that there are various reasons and intentions behind a WTD. Its expression is neither synonymous with suicidality nor necessarily associated with the desire for assisted suicide. Healthcare professionals and caregivers should be aware that a WTD is an appropriate and not a pathological phenomenon. Before possible solutions are considered, details and background of a WTD must be explored within a holistic approach, as a WTD is often ambivalent, dynamic, inconsistent or even contradictory. The feeling of being a burden to others deserves special attention. In this context, palliative sedation (PS) should be viewed critically. Most international guidelines do not consider"existential suffering" in the absence of physical symptoms as an indication for PS. So far, no consensus based on empirical data has been reached among experts. Also, the criteria for when a WTD is to be categorized as"constant", remains controversial. In the presence of depression, the potential therapeutic effect of medication and psychotherapies should be awaited. The aspects mentioned are particularly important concerning normative and legislative issues. © 2021 Mediengruppe Oberfranken - Fachverlage GmbH & Co. KG. All rights reserved.

Language: de

Keywords

existential suffering; palliative sedation; wish to die (WTD); wish to hasten death (WTHD)