Desire to Die Statements in the Era of Voluntary Assisted Dying: An Audit of Patients Known to a Victorian Consultation-Liaison Palliative Care Service

Adams, V; Katz, NT; Philip, JAM; Gold, M

Author(s): Adams, V; Katz, NT; Philip, JAM; Gold, M;
Details: Publication Year 2022-10,Volume 39,Issue #10,Page 1203-1209
Journal Title: American Journal of Hospice & Palliative Care
Publication Type: Research article
Abstract: Objectives: In the new era of voluntary assisted dying (VAD) legislation in Australia, this study aimed to explore (1) underlying reasons for desire to die statements (DTDSs), (2) clinician responses to DTDSs and (3) whether DTDSs were a true request for VAD. Methods: Clinical audit using an existing prospectively collected quality assurance database, supplemented by electronic medical records. Patients known to a consultation-liaison palliative care service who expressed a DTDS between October 2019 and September 2020 were included. Results: Forty-one patients were included; 29 (71%) were male, 29 (71%) had a malignancy and 31 (76%) expressed a DTDS more than once. Uncontrolled psychological symptoms were present more often than physical (n = 30 vs 19 [73% vs 46%]), yet physical symptoms were addressed more frequently than psychological (80% vs 63% of the time). Based on available data, the VAD assessment process was commenced by 7 patients, and death by VAD occurred for 2 patients. Conclusions: In our study, DTDSs were complex, multi-layered requests that more commonly reflected psychological rather than physical suffering. Though VAD is now legally possible, a DTDS was not always synonymous with a request for VAD. Key to responding to these requests are high levels of clinician confidence and communication skills. Training in this area remains critical for the experience of both patients and clinicians.
Keywords: Australia; Female; Humans; Male; *Neoplasms; Palliative Care; Referral and Consultation; *Suicide, Assisted/psychology; death talk; desire to die statement; euthanasia; existential; voluntary assisted dying
Department(s): Palliative Care
PubMed ID: 35045758
Publisher's Version: https://doi.org/10.1177/10499091211069620
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-09-25 04:53:30

Last Modified: 2024-09-25 05:00:19