The synthesis included studies conducted in Canada, 1 6 Australia, 2 China 7 and the USA. In 2012, our group published a systematic review and interpretative synthesis 5 of then-published qualitative studies of the WTHD in seeking to understand the experience of patients with serious or incurable illness who expressed such a wish. Furthermore, it is important not to confuse, for example, a wish to die in someone who is not considering actually hastening his/her death with a will to die in someone who takes action towards dying. Thus, if we are to understand what patients actually mean when they say that they ‘no longer wish to live in this way’, we must explore their personal history, attitudes, beliefs and thoughts. Interpretative analysis of the WTHD suggests that, in addition to these potential motivations, attention must focus on the meanings, functions and intentions that underlie the expression of a WTHD. 2 3 Thus, factors such as loss of self, loss of the sense of dignity, loss of autonomy, fear about the future, fear of suffering and fear of being a burden to others are reported among the main triggers of a wish to hasten death (WTHD). Several qualitative studies have explored the wish to die in patients with advanced disease highlighting the important role played by psychosocial and existential/spiritual factors, alongside physical symptoms. Thus, while cross-sectional studies offer valuable information about what may trigger a wish to die, the fluctuating, ambivalent, subjective and complex nature of such wishes requires a more detailed examination of patients’ experiences. Why do some patients with advanced disease wish to hasten their death? What meaning does this wish hold for them? What is the experience of a person who feels such a wish? To what extent do commonalities exist among those who come to feel this wish?Īlthough the desire to die has traditionally been seen to result from physical suffering, research suggests that this explanation is reductionist 1 and that such a wish must be understood in the context of patient experience. What is often overlooked is the common thread that links all those persons who contemplate ending their life: the desire to die or to hasten their death.

Debate, however, often centres around the implications for society or the existing legal framework. Across the world, opinions and attitudes towards this issue differ widely.

Few issues in modern society generate as much controversy as euthanasia and assisted suicide (EAS) among people facing an advanced illness.

Hasten death