The Patient's Wish to Die: Research, Ethics, and Palliative Care
Christoph Rehmann-Sutter, Heike Gudat, and Kathrin Ohnsorge
Abstract
Despite having the best palliative care, some patients develop a wish to die. The wish to die under these circumstances need not be symptomatic of suboptimal care. However, for those involved in their care, being confronted with a patient who expresses such a wish can be morally, intellectually, and emotionally challenging. This book explores the subjective experience and needs of patients who hold such wishes, the meanings these wishes may have for them, and some of the moral and practical challenges presented by caring for these patients. The book assembles chapters by some of the most impor ... More
Despite having the best palliative care, some patients develop a wish to die. The wish to die under these circumstances need not be symptomatic of suboptimal care. However, for those involved in their care, being confronted with a patient who expresses such a wish can be morally, intellectually, and emotionally challenging. This book explores the subjective experience and needs of patients who hold such wishes, the meanings these wishes may have for them, and some of the moral and practical challenges presented by caring for these patients. The book assembles chapters by some of the most important authors working on this issue. Some come from countries where assisted dying is legally permitted, others from countries where it is not. The first main part is dedicated to recent qualitative or mixed-methods research on this topic. These studies focus on patients’ subjective experiences that lead to these wishes, and propose different conceptual frameworks for them. The next part includes discussions of key ethical ideas, such as autonomy, or the permissibility of assisted dying. The chapters also explore the moral work of wishes as a space of moral agency by the person holding the wish. Practical reflections on the responsibility for knowing what a patient wishes and how to foster constructive deliberation processes around this wish are also addressed. This is followed by a section considering wishes to die from the perspectives of healthcare professionals, including issues of communication, spirituality, and care. An empathetic response requires good communication skills, attention to the patients’ narratives, and respect for their particular subjectivity.
Keywords:
wish to die,
palliative care,
assisted dying,
autonomy,
spirituality,
communication,
patients’ narratives
Bibliographic Information
Print publication date: 2015 |
Print ISBN-13: 9780198713982 |
Published to Oxford Scholarship Online: August 2015 |
DOI:10.1093/acprof:oso/9780198713982.001.0001 |
Authors
Affiliations are at time of print publication.
Christoph Rehmann-Sutter, editor
Professor of Theory and Ethics in the Biosciences, Institute for the History of Medicine and Science Studies, Lübeck, Germany
Heike Gudat, editor
Head of the hospital for palliative care, Hospiz im Park, Hospital for Palliative Care, Arlesheim, Switzerland
Kathrin Ohnsorge, editor
Researcher at the hospital for palliative care, Hospiz im Park, Hospital for Palliative Care, Arlesheim, Switzerland
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