What lies behind a request for euthanasia or assisted suicide? A pilot study

Aims. - The primary objective of the study was to evaluate the frequency and nature of requests for euthanasia and/or assisted suicide by trying to appreciate their meaning in order to improve the method and then lead a multicentre work with an epidemiological and understanding goal. Methods. - This single-centre, prospective survey was conducted over one year. A communication plan has been developed to include all patients in palliative situations making a request in the university hospital of Besancon, France. Two hetero questionnaires were carried out on the basis of previous work and data from the literature, noted: (1) when the patient expressed a desire to accelerate the end of life; (2) in case of persistent demand beyond 15 days. Results. - The request frequency was about 2%. A quarter of the requests was related to the announcement of the diagnosis; more than half with the announcement of the prognosis. Forty percent of patients suffered from pain and loss of autonomy was their greatest fear. No link could be established between familial or professional environment and requests. A feeling of unworthiness was present in 11 of 15 patients. The notion of a difficult end-of-life or death was noted in six patients. Conclusion. - This study is broadly consistent with the literature data. However, the method needs to be improved to analyse in greater detail the thoughts and feelings of patients who request euthanasia or assisted suicide. It appears necessary, in view of a multicentre study, to optimize the collection of data and perform a qualitative research based on interviews with people who make this request. (C) 2015 Elsevier Masson SAS. All rights reserved.