The desire for or wish to hasten death as a phenomenon is distinguished from the act of hastened death because having a wish to die does not mean that a person will act on the desire to die. People who intentionally hasten death have been described as individuals “who have been involved in decisions about their care” who want to have control over the circumstances of their death and who may act on their wish to die with or without assistance from another individual. The term ‘hasten death’ is used because not all hastened deaths of people who are considered terminally ill may be considered suicide.
Some of these individuals are in receipt of palliative care services, however, they are deciding to die by suicide or hasten their death without legal lethal means. Several jurisdictions around the world have passed assisted dying laws that allow a physician, or, in some areas, a nurse practitioner to legally prescribe and/or administer life-ending medications to individuals faced with a serious illness.
More research is needed to help clarify what hastened death means in a palliative care context and identify how and if assisted dying impacts issues of suicide in palliative care settings. The included literature suggests improved communication among professionals is needed but does not explicitly identify when a hastened death is deemed a suicide in areas where assisted dying is practiced. There are a range of experiences and emotions professionals’ experience with patients who die by euthanasia, assisted suicide, or hasten death without assistance. Published studies about professionals’ experiences from areas with legalised assisted dying includes limited information about patients who hasten death outside legal guidelines, die by suicide without assistance, or if the law impacts suicide among palliative care patients. ResultsĪ total of 1518 titles were screened resulting in thirty studies meeting eligibility criteria for this review. Quality assessment used the Hawker framework. MethodsĪMED, CINAHL Complete, PsycINFO, PubMED, and Academic Search Ultimate were searched for articles from inception through June 2018. This systematic review aims to summarise evidence of palliative care professionals’ experiences of patients who died by suicide or hastened death in areas where assisted dying is legal and to understand when hastened death is considered to be a suicide. Laws allowing assisted suicide and euthanasia have been implemented in many locations around the world but some individuals suffering with terminal illness receiving palliative care services are hastening death or die by suicide without assistance.
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