The desire for hastened death in individuals with advanced cancer: A longitudinal qualitative study
The desire for hastened death in individuals with advanced cancer: A longitudinal qualitative study
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DOI：
10.1016/j.socscimed.2009.04.021
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发表时间：
2009-07-01
影响因子：
5.4
通讯作者：
Rodin, Gary
中科院分区：
文献类型：
--
作者：
Nissim, Rinat;Gagliese, Lucia;Rodin, Gary
需要对晚期癌症背景下的加速死亡 (DHD) 愿望进行研究，以解决其引发的临床、伦理和法律问题。本定性研究的目标是了解晚期癌症患者所表达的 DHD 经历，并了解其随时间的演变。参与者是 27 名年龄在 45-82 岁的晚期肺癌或胃肠道癌症患者。参与者是通过理论抽样从加拿大多伦多一家大型癌症中心的门诊诊所招募的，并在一系列开放式访谈中被询问有关 DHD 的问题，直至死亡。基于扎根理论方法，总共分析了 54 份访谈。研究发现，DHD 在晚期癌症方面的经验可分为三个不同的类别：i) DHD 作为假设的退出计划； ii) DHD 作为绝望的表达； iii) DHD 作为放手的表现。每个类别都有独特的时间和质量特征。这些类别的识别对于 DHD 的未来研究、对表达这种愿望的个体进行临床干预的标准以及对晚期疾病个体的医生协助自杀和安乐死的公开辩论可能很重要。 (C) 2009 Elsevier Ltd. 保留所有权利。
Research is needed on the desire for hastened death (DHD) in the context of advanced cancer in order to address the clinical, ethical, and legal questions that it raises. The goal of the present qualitative study was to understand the experience of the DHD as expressed by individuals with advanced cancer, and to understand how it evolves over time. Participants were 27 ambulatory patients aged 45-82 years with advanced lung or gastrointestinal cancer. Participants were recruited through theoretical sampling from outpatient clinics at a large cancer center in Toronto Canada, and were asked about the DHD in serial, open-ended interviews until the point of death. A total of 54 interviews were analyzed based on the grounded theory method. The experience of the DHD in the context of advanced cancer was found to be subsumed under three distinct categories: i) DHD as a hypothetical exit plan; ii) DHD as an expression of despair; and iii) DHD as a manifestation of letting go. Each category had unique temporal and qualitative characteristics. The identification of these categories may be important to inform future research on the DHD, the criteria for clinical intervention in individuals who express this desire, and the public debate about physician-assisted suicide and euthanasia for individuals with advanced disease. (C) 2009 Elsevier Ltd. All rights reserved.