Journal of pain and symptom management · 2026
Family Experiences of Witnessing Patients' Desire to Hasten Death in Japanese Palliative Care Units.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Maeda Sayaka, Morita Tatsuya, Tanimukai Hitoshi, Hatano Yutaka, Tsuneto Satoru, Mori Masanori, Aoyama Maho, Miyashita Mitsunori
Аннотация
CONTEXT: Desire to hasten death commonly affects terminally ill cancer patients, yet family members' experiences remain poorly understood.
OBJECTIVES: To examine how families experienced patients' desire to hasten death, and explore factors potentially associated with related distress.
METHODS: Using data from a nationwide bereaved family survey in Japanese palliative care units, we analyzed 475 valid responses (of 904 distributed; 52.5%), focusing on the 114 respondents whose patients had expressed a desire to hasten death during the final month of life. Emotional responses were assessed using a 16-item instrument, and distress-associated factors were examined using univariable analyses.
RESULTS: A desire to hasten death was reported by 24% of respondents (114/475), 35% of whom involved an explicit request to hasten death (40/114). Physical symptoms were common reasons (80%), although existential distress was also frequently reported (65%). A total of 75.8% of respondents (72/95) reported being distressed or very distressed by hearing the desire. Approximately 70% of respondents considered the patient's desire understandable and supported alleviation of suffering, including sedation, whereas nearly 30% wished that the desire could be fulfilled. About half reported uncertainty regarding how to respond and feelings of helplessness. One-quarter reported unmet needs concerning emotional support and guidance. In univariable analyses, greater emotional distress was associated with a spousal relationship, desire rooted in existential suffering, coping difficulty, and emotional overwhelm.
CONCLUSION: A patient's desire to hasten death imposes a marked emotional burden on family members. Proactive emotional support is needed, as distress persists even when the desire is cognitively understood.
OBJECTIVES: To examine how families experienced patients' desire to hasten death, and explore factors potentially associated with related distress.
METHODS: Using data from a nationwide bereaved family survey in Japanese palliative care units, we analyzed 475 valid responses (of 904 distributed; 52.5%), focusing on the 114 respondents whose patients had expressed a desire to hasten death during the final month of life. Emotional responses were assessed using a 16-item instrument, and distress-associated factors were examined using univariable analyses.
RESULTS: A desire to hasten death was reported by 24% of respondents (114/475), 35% of whom involved an explicit request to hasten death (40/114). Physical symptoms were common reasons (80%), although existential distress was also frequently reported (65%). A total of 75.8% of respondents (72/95) reported being distressed or very distressed by hearing the desire. Approximately 70% of respondents considered the patient's desire understandable and supported alleviation of suffering, including sedation, whereas nearly 30% wished that the desire could be fulfilled. About half reported uncertainty regarding how to respond and feelings of helplessness. One-quarter reported unmet needs concerning emotional support and guidance. In univariable analyses, greater emotional distress was associated with a spousal relationship, desire rooted in existential suffering, coping difficulty, and emotional overwhelm.
CONCLUSION: A patient's desire to hasten death imposes a marked emotional burden on family members. Proactive emotional support is needed, as distress persists even when the desire is cognitively understood.