Desire for Hastened Death Amongst Veterans Facing Terminal Illness. VA St. Louis Health Care System. Anupam Agarwal, MD, MSHA Medical Director, Palliative Care Program Associate Chief of Staff VA St. Louis Health Care System. Mark F. Heiland Ph.D. Clinical Psychologist
VA St. Louis Health Care System
Anupam Agarwal, MD, MSHA
Medical Director, Palliative Care Program
Associate Chief of Staff
VA St. Louis Health Care System
Mark F. Heiland Ph.D.
Siteman Cancer Center, Barnes Jewish Hospital
Washington University at St. Louis
Disclosure: IllnessThere are no relevant financial relationships to disclose
Desire for Hastened Death
A wish for death due to Intent to end life due to medical condition medical condition
A wish for death due to Intent to end life due to
psychiatric condition or psychiatric condition or
psychological distress psychological distress
Counter transference Elicit emotion
Contributing factors Specific concerns
Blackhall, L.J. (2009). Cultural diversity and palliative care. In Chochinov, H.M. & Breitbart, W. (Eds.), Handbook of psychiatry in palliative medicine (2nd ed., pp. 186-201). New York: Oxford University Press, Inc.
Chochinov, H.M., Wilson, K.G., Enns, M. & Lander, S. (1998). Depression, hopelessness, and suicidal ideation in the terminally ill. Psychosomatics 39 (4), 366-369.
Chochinov, H.M., Hack, T., Hassard, T., Kristjanson, L.J., McClement, S. & Harlos, M. (2005). Understanding the will to life in patients near death. Psychosomatics, 46 (1), 7-10.
Hudson, P. L., et al. (2006). Responding to desire to die statements from patients with advanced disease: Recommendations for health professionals. Palliative Medicine, 20, 703-710.
Hudson, P.L., et al. (2006). Desire for hastened death in patients with advanced disease and the evidence base of clinical guidelines: a systematic review. Palliative Medicine, 20, 693-701.
Kissane, D.W., et al. (2004). The demoralization scale: A report of its development and preliminary validation. Journal of Palliative Care, 20 (4), 269-276.
Leeman, C.P. (2009). Distinguishing among irrational suicide and other forms of hastened death: Implications for clinical practice. Psychosomatics, 50 (3), 185191.
McLean, L.M. & Jones, J. M. (2007). A review of distress and its management in couples facing end-of-life cancer. Psycho-Oncology 16, 603-616.
McPherson, C. J., Wilson, K.G. & Murray, M. A. (2007) Feeling like a burden to others: a systematic review focusing on the end of life. Palliative Medicine 21, 115-128.
Nissam, R., Gagliese, L. & Rodin, G. (2009). The desire for hastened death in individuals with advanced cancer: A longitudinal qualitative study. Social Science & Medicine, 69, 165-171.
Olden, M., Pessin, H., Lichtenthal, W.G. & Breitbart, W. (2009). Suicide and the desire for hastened death in the terminally ill. In Chochinov, H.M. & Breitbart, W. (Eds.), Handbook of psychiatry in palliative medicine (2nd ed., pp. 101-112). New York: Oxford University Press, Inc.
Peteet, J.R., Meyer, F., deLima Thomas, J., Vitagliano, H.L. (2009). Psychiatric indications of admission to an inpatient palliative care unit. Journal of Palliative Medicine, 12 (6), 521-524.
Ransom, S., Sacco, W.P., Weitzner, M.A., Azzarello, L. M. & McMillan. S.C. (2006).
Interpersonal factors predict increased desire for hastened death in late-stage cancer
patients. Annals of Behavioral Medicine, 31 (1), 63-74.
Rodin, G., Lo, C., Mikulincer, M., Donner, A., Gagliese, L., & Zimmermann, C. (2008).
Pathways to distress: The multiple determinants of depression, hopelessness, and
desire for hastened death in metastatic cancer patients. Social Science and Medicine,
Rosenfeld, B., et al. (1999). Measuring desire for death among patient’s with HIV/AIDS:
The schedule of attitudes toward hastened death. American Journal of Psychiatry, 156
Schroepfer, T. A. (2008). Social Relationships and their role in the consideration to
hasten death. The Gerontologist, 48 (5), 612-621.
Spira, J. L. (2000). Existential psychotherapy in palliative care. Chochinov, H.M. &
Breitbart, W. (Eds.), Handbook of psychiatry in palliative medicine (1st ed., pp197-
214). New York: Oxford University Press.