A wish to die or a cry for help?

Michael Cook
26 May 2012
Reproduced with Permission

"He's sick and tired of the pain and indignity and wants to die" is the most common reason for assisted suicide and euthanasia. However, a thought-provoking study in the journal PLoS One by researchers from the Universitat Internacional de Catalunya, in Barcelona, suggests that this statement raises far more questions than it answers.

In the first place, the wish to hasten death, or WTHD as they call it, is very poorly defined.

"…studies have not distinguished clearly between a general wish to die, the wish to hasten death and requests for euthanasia or physician-assisted suicide. Thus, one finds the indistinct use of terms such as 'wish to die', 'want to die' or 'desire to die', as well as 'wish to hasten death', 'desire for early death', and other related expressions or synonyms for requests for euthanasia or assisted suicide, such as 'death-hastening request', 'request to die', 'request for euthanasia' and 'request for physician-assisted suicide'."

Second, the WTHD can change with time. Finally, there is a wide range of factors which provoke the WTHD, including pain, depression, hopelessness, the feeling of being a burden and loss of autonomy.

After synthesising a number of studies of patients who had asked for their death to be hasten, the Catalan researchers concluded that "Overall, the WTHD emerges as a phenomenon that does not necessarily imply the wish to die, and it appears as a response to an overwhelming emotional distress among patients in the advanced stages of disease."