"Withstanding ambivalence is of particular importance"-Controversies among experts on dealing with desire to die in palliative care.
Adult
Attitude to Death
Communication
Data Interpretation, Statistical
Death
Delphi Technique
Expert Testimony
Female
Germany
Health Personnel
Humans
International Cooperation
Male
Middle Aged
Palliative Care
/ methods
Professional-Patient Relations
Qualitative Research
Surveys and Questionnaires
Uncertainty
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
23
07
2020
accepted:
01
09
2021
entrez:
24
9
2021
pubmed:
25
9
2021
medline:
15
12
2021
Statut:
epublish
Résumé
In order to investigate controversies surrounding the desire to die phenomenon in palliative care by analyzing expert opinions on the topic, we carried out a secondary qualitative data analysis of free text comments collected during a Delphi survey that was designed to develop a conversation aid for dealing with desire to die in everyday clinical practice. Between 01/2018 and 03/2018, a two-round Delphi survey was carried out with national (German) and international palliative care experts. Free text comments were reinvestigated to identify controversies surrounding the desire to die phenomenon. An additional in-depth analysis focused on statements expressing attitudes towards proactively addressing (potential) desires to die. Within the Delphi survey, 103 of 149 multi-professional participants (almost all of them with practical and only six with exclusively theoretical expertise in palliative care) generated 444 free text comments. Thereof, we identified three main categories related to dealing with desire to die: "outer framework", "extended care system" and "health-professional-patient-relationship". Ambivalences, taboos and uncertainties surrounding desire to die in palliative care became apparent. Experts are divided concerning the practice of proactively addressing desire to die. Even if these conversations-especially the proactive approach-are also viewed critically, we conclude that open-ended and respectful communication about desire to die between health professionals and patients can be understood as an eligible intervention in palliative care. Proactively addressing the topic is a possible way to open up such conversations.
Identifiants
pubmed: 34559828
doi: 10.1371/journal.pone.0257382
pii: PONE-D-20-22881
pmc: PMC8462710
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0257382Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Palliat Med. 2017 Sep;31(8):684-706
pubmed: 28190381
Palliat Med. 2010 Dec;24(8):751-2
pubmed: 21139046
BMJ. 2010 Mar 23;340:c1345
pubmed: 20332506
Front Neurol. 2018 Jul 27;9:603
pubmed: 30100896
Cancer. 2018 Aug 1;124(15):3231-3239
pubmed: 29757459
Onkologe (Berl). 2016 Oct;22(10):725-736
pubmed: 28265177
BMC Palliat Care. 2018 Feb 20;17(1):30
pubmed: 29458344
Suicide Life Threat Behav. 2018 Oct;48(5):531-543
pubmed: 28678380
Am J Psychiatry. 1995 Aug;152(8):1185-91
pubmed: 7625468
J Palliat Med. 2004 Feb;7(1):19-25
pubmed: 15008126
J Nurs Manag. 2018 Jan;26(1):19-25
pubmed: 28695723
Clin Pract Epidemiol Ment Health. 2019 Mar 29;15:64-73
pubmed: 31015857
BMJ Support Palliat Care. 2016 Jun;6(2):170-7
pubmed: 24644212
Psychol Bull. 2007 Mar;133(2):328-45
pubmed: 17338603
Psychol Med. 2014 Dec;44(16):3361-3
pubmed: 24998511
CMAJ. 2019 Jan 7;191(1):E22-E23
pubmed: 30617232
BMJ Support Palliat Care. 2020 Mar;10(1):105-110
pubmed: 31391175
J Palliat Med. 2018 Mar;21(3):322-327
pubmed: 28972862
Med Teach. 2005 Nov;27(7):639-43
pubmed: 16332558
Palliat Med. 2019 Jun;33(6):570-577
pubmed: 30688146
Ann Fam Med. 2011 Mar-Apr;9(2):100-3
pubmed: 21403134
JAMA. 2002 Aug 14;288(6):756-64
pubmed: 12169083
Soc Sci Med. 2009 Jul;69(2):165-71
pubmed: 19482401
Curr Opin Psychol. 2018 Oct;23:124-128
pubmed: 29709725
Perspect Psychol Sci. 2009 Sep;4(5):496-521
pubmed: 26162223
Postgrad Med J. 2016 Aug;92(1090):466-70
pubmed: 27153866
Crisis. 2011;32(4):194-203
pubmed: 21940260
J Am Med Dir Assoc. 2014 Jul;15(7):477-489
pubmed: 24598477
Curr Opin Support Palliat Care. 2012 Dec;6(4):471-82
pubmed: 23095554
BMC Palliat Care. 2019 Jan 21;18(1):8
pubmed: 30665379
Support Care Cancer. 2011 Jun;19(6):771-7
pubmed: 20422231
N Engl J Med. 2019 Jan 17;380(3):211-213
pubmed: 30650331
Palliat Med. 2016 Feb;30(2):104-16
pubmed: 26586603
Int J Psychiatry Clin Pract. 2021 Mar;25(1):2-18
pubmed: 32729770
BMC Palliat Care. 2020 Apr 16;19(1):49
pubmed: 32299415
BMC Health Serv Res. 2019 Mar 12;19(1):157
pubmed: 30866912
Am J Bioeth. 2019 Oct;19(10):63-65
pubmed: 31557105
Palliat Med. 2006 Oct;20(7):703-10
pubmed: 17060269
PLoS One. 2013 Dec 10;8(12):e80797
pubmed: 24339883
J Med Ethics. 2020 Jun;46(6):416-417
pubmed: 32220872
Am J Bioeth. 2019 Dec;19(12):44-45
pubmed: 31746708
Palliat Med. 2006 Jun;20(4):425-32
pubmed: 16875113
Clin Gerontol. 2020 Jan-Feb;43(1):4-16
pubmed: 31615349
PLoS One. 2016 Jan 04;11(1):e0146184
pubmed: 26726801
Soc Sci Med. 2009 Feb;68(3):562-9
pubmed: 19059687
BMJ. 2012 May 14;344:e3356
pubmed: 22586235
PLoS One. 2019 Jan 17;14(1):e0210784
pubmed: 30653575
Ann Palliat Med. 2021 Mar;10(3):3594-3610
pubmed: 33440974
BMJ Open. 2017 Sep 29;7(9):e016659
pubmed: 28965095
Psychooncology. 2016 May;25(5):536-43
pubmed: 26374399
Death Stud. 2014 Jul-Dec;38(6-10):582-8
pubmed: 24499447
JAMA. 2009 Jul 8;302(2):195-7
pubmed: 19584351
J Pain Symptom Manage. 2007 Jun;33(6):661-75
pubmed: 17531909
Acad Med. 2014 Sep;89(9):1245-51
pubmed: 24979285
PLoS One. 2017 Aug 1;12(8):e0180395
pubmed: 28763445
Palliat Support Care. 2020 Oct;18(5):528-536
pubmed: 32131932