Euthanasia and assisted suicide requests of end-of-life patients hospitalised in palliative care units: A qualitative wording analysis study

Objectives. - Whilst euthanasia and assisted suicide are forbidden by French Law, patients at the end of their life, hospitalized in Palliative Care Units (PCU) sometimes express such requests. The "DESA study" focused on the expression of patients' requests for euthanasia and assisted suicide, i.e. how patients worded their wishes. The aim is to identify, from the "raw wording"of these requests, their common features, specificities and evolution. Patients/materials and methods. - This qualitative study took place in 11 French PCU dur-ing one year. It included adult patients who had made an explicit request for euthanasia or physician-assisted suicide to a health professional. According to the principles of grounded the-ory, semi-structured interviews were conducted within 48 hours of the initial request (D0), and then a week after this request (D7). Results. - Eighteen Patients were initially interviewed. Only 9 were interviewed at D7. At D0, the initial request is a request for euthanasia. This request is expressing physical and psycho-logical suffering, trauma and representations of death. At D7, we observe a semantic change: the request is less explicit and requires less intervention by a third party. It remains centred on death without suffering. Conclusion. - Healthcare providers need to actively listen to the request being made to be able to understand the meaning of the words and their function. It is their nuance, variety and evolution that help to better identify patients' needs. (C) 2022 Elsevier Masson SAS. All rights reserved.