Evolution of requests for euthanasia and assisted-suicide as perceived by healthcare providers

Objectives. - Patients at the end of their life sometimes express requests for euthanasia or assisted suicide. Our research aimed to analyze the evolution of these requests. Patients, materials and methods. - Our one-year prospective cohort study surveyed, across a French region, healthcare providers that received a request for euthanasia or assisted-suicide from patients at the end of life. They were asked to fill-in questionnaires during one week. Results. - Fifty-five requests could be analyzed. One week after the initial request, 23 patients repeated their request, 22 did not and 10 patients died. For the 23 repeat requests, healthcare professionals reported patients' hopelessness about their situation. For the 22 non-repeated requests, the majority of healthcare providers reported that they had not discussed the subject again and that patients felt resigned, while other described patients who perceived hope in their future. Conclusion. - The results highlight that it is difficult within the therapeutic relationship to initiate a discussion about the request. These requests call for a listening ear. Ethical formal training merits to be encouraged and promoted for health care professionals. By providing guidance to professionals, discomfort would be reduced and it provides an opportunity for patients to express and for healthcare providers to explore end-of-life needs. (c) 2022 The Author(s). Published by Elsevier Masson SAS. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).