Saturday, March 21, 2009


Euthanasia is defined as the intentional termination of someone’s life by someone other than the person concerned, at the person’s request. Many people with in the advanced stages of illness will request a physician to help in a painless death. The difficulty in dealing with such requests is to ascertain what reason the request was made. Is it caused by psychological distress, or merely an insincere comment not meant to be interpreted literally as a death wish? Moral issues aside, let’s assume that euthanasia is legal, and the physician is required to respond to such death requests professionally. Discussing the topic of euthanasia with a patient is tricky, the consequences could be emotionally draining, unhelpful to hopefulness, or psychologically harmful to the patient. Another issue is the preparedness of doctors or nurses to respond to desire to die statements (DTDS). That preparedness could include legal and professional knowledge and understanding, saying the right thing at the right time, etc. These fears can lead professionals to ignore DTDSs hindering the patient’s ability to express any psychosocial concerns, thinking that the physician won’t be able to help, or is unconcerned with his/her personal well-being. Another issue regarding DTDSs is that these desires can fluctuate over time. How does a physician gauge the sincerity of such a request? Research suggests that interactions that convey empathy for the patient’s distress and active listening assist psychological adjustment, that information and comprehensive understanding about what to expect in the future promotes psychological well-being, and an opportunity to discuss feelings with a health professional reduces psychosocial distress. In light of these findings, it is important that health care professionals be adequately trained in handling DTDSs and respond to them appropriately. As I said before, I have ignored whether or not physician assisted suicide is morally right or not, my focus is to point out what difficulties arise in responding to a DTDS and what research shows can help a patient in a palliative care setting.