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The Patient's Wish to DieResearch, Ethics, and Palliative Care$
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Christoph Rehmann-Sutter, Heike Gudat, and Kathrin Ohnsorge

Print publication date: 2015

Print ISBN-13: 9780198713982

Published to Oxford Scholarship Online: August 2015

DOI: 10.1093/acprof:oso/9780198713982.001.0001

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Intentions, motivations, and social interactions regarding a wish to die

Intentions, motivations, and social interactions regarding a wish to die

Chapter:
(p.81) Chapter 8 Intentions, motivations, and social interactions regarding a wish to die
Source:
The Patient's Wish to Die
Author(s):

Kathrin Ohnsorge

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780198713982.003.0008

When patients in palliative care express a wish to die (WTD), adequate and sensitive responses require a nuanced understanding of these wishes. This chapter describes a qualitative study in which 30 patients, their relatives, and caregivers were interviewed. These interviews provided insight into patients’ complex, often ambivalent processes of decision-making at the end of life. Three dimensions were identified that were important for understanding WTD statements: intentions, motivations, and constitutive social interactions. The intention reveals how someone wishes to die (with or without also wishing to hasten death; with or without undertaking actions towards it). Nine different types of intentions were found. Motivations explain why, from the patients’ perspective, a WTD is present. Motivations vary with the reasons, meanings, and functions of WTD statements. Social interactions and the sociocultural contexts in which the WTD is situated often influence and co-constitute a particular WTD in a decisive way.

Keywords:   wish to die, end of life, palliative care, meanings, motivations, decision-making, social interactions

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