SAVES is not affiliated with Exit International / Dr Philip Nitschke and opposes the public availability of a 'peaceful pill'.

Recent research has been conducted involving 36 patients admitted to a hospice, and 18 carers of now deceased patients of a palliative care service who participated in focus groups on end-of-life issues (1). The research revealed that areas of greatest patient concern were privacy and autonomy, and lack of information about physical changes and medication which could be anticipated as death approached. Patients were also worried about the possibility of ‘bizarre or undignified behaviour and of unsightly physical change that may distress their families’ during the last moments of their lives. The desire to shorten life was expressed in different ways by all patients in the research. The patients’ privacy concerns were from the risk of families usurping decision-making, and some patients were concerned about ‘the forced intimacy that some hospice staff appeared to promote and which the patients found distasteful’. Some patients confirmed that the hospice model of ‘the family as unit of care’ created tension about information sharing.

Patient carers recounted problems in accessing services and support, felt they did not have sufficient information about the patients’ illnesses, and were insistent that this should be provided even against patient wishes.

Of particular note in this research was that all interviewed patients expressed thoughts which included the desire to shorten life. These ranged from fleeting thoughts that life was not worth living, or had gone on long enough, through an expressed wish that they were dead, or an isolating preoccupation with death, to communicating a plan or well-reasoned course of action for suicide.

Other patients expressed reasons why they should not take their lives. While some gave religious reasons against suicide, the most frequently stated reason for any reticence to act was the uncertainty of how to do so without increasing their suffering or implicating others. Other reasons for not acting were concerns over the reactions of others, rather than justifiability in their own minds. The research findings were that two problematic issues had been revealed. These were the ‘family centred model of palliative care’, and the differences between patient views on the psychosocial aspects of dying and those of Palliative Care. The research concluded:

... it was important that the commonest reasons patients gave for not acting on their desire to shorten their lives were practical, and that concerns about the morality of suicide were infrequently expressed.

Reference: Terry, W; Olson, G; Wilss, L and Boulton-Lewis (2006), G "Experience of dying: concerns of dying patients and of carers", Internal Medicine Journal, 36 338-346.