Is trained communication about desire to die harmful for patients receiving palliative care? A cohort study

SAGE Palliative Medicine & Chronic Care

This episode features Professor Raymond Voltz, Kathleen Boström and Dr Kerstin Kremeike (Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany. Patients in palliative care frequently express a desire to die that rarely leads to a request for medical aid in dying. Fearing to cause harm, health professionals report uncertainty regarding proactively approaching the topic with their patients. Suicidology research suggests that there is no iatrogenic risk in asking about suicidality, but it remains unclear whether this analogy holds for non-psychiatric palliative patients with or without a desire to die. Independent of age, gender, diagnoses, and current desire to die, open conversations about desire to die through trained health professionals do not harm palliative patients. Desire to die conversations might lead to an at least temporary improvement in patients with medium to severe depression. Health professionals can feel encouraged to promote an open and respectful atmosphere of conversation about existential issues at the end of life including possible desire to die.