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.