Prof. Dr. phil., dipl. biol. Christoph Rehmann-Sutter
Wishes to Die of Palliative Cared People in Serious Illness
Funded 2008-2011 by Oncosuisse, the Gottfried and Julia Bangerter-Rhyner Foundation and the Förderstiftung HOSPIZ IM PARK, and 2013-2016 by the Swiss National Science Foundation, National Research Program 67 "End of Life".
Hemmi Foundation Research Award 2017 (press release)
Patients suffering from a serious illness that may lead to death sometimes express the wish to no longer receive curative treatment. Some of them explain this by saying that they want to die. It is well known that wishes to die occur even under conditions of good palliative care and do not necessarily have to be an expression of pain or inadequate pain therapy. Rather, these wishes have a complex background that ultimately refers to people's existential confrontation with death. Dying wishes are closely related to the treatability and course of a disease, to quality of life, to biography, to needs, attitudes, and concerns of those affected, but also to the immediate environment and society.
In an interpretative phenomenological study lasting almost 10 years, initiated in the Basel area in various settings in 2008 and continued until 2017, 248 in-depth qualitative interviews provided evidence on the intentions, reasons, meanings, and functions of dying wishes. A comparative study of 62 persons receiving palliative care and their medical and personal environments from four different groups was conducted: cancer patients, neurodegenerative diseases, organ failure, and frail persons in old age.
The study provided insight into how dying wishes arise, how they are structured, how they change over time and over the course of an illness, and how they are balanced against each other, or with living wishes. These findings prompted a series of fundamental medical ethical and philosophical investigations. The findings are important for improving palliative care and relevant to the public debate on issues of euthanasia. They are helpful in providing appropriate care and support for those affected.
Research Team:
Prof. Dr. Christoph Rehmann-Sutter, University of Lübeck, Dr. med. Heike Gudat, Chief Physician at Hospiz im Park, Clinic for Palliative Care, Arlesheim (co-leader).
Dr. phil. Kathrin Ohnsorge, MAS, Dr. phil., lic. oec. publ. Nina Streeck, Lucia Stäubli, art and talk therapist, St. Claraspital, Basel, Heidi Gass, qualified nurse specializing in palliative care, Arlesheim.
Presentation of the study in the German Medical Journal
Dissertations:
Dr. phil. Kathrin Ohnsorge
Lisa-Marie Müller
Franziska Rau
Alexandra Ridder
Carola Röder
Linda Sommer
Berlin: Kadmos Verlag 2018.
With contributions from Emmanuelle Belanger, Corina Caduff, Heike Gudat, Luise Metzler, Lisa-Marie Müller, Kathrin Ohnsorge, Simon Peng-Keller, Theda Rehbock, Christoph Rehmann-Sutter, Clive Seale, Elisabeth Schömbucher-Kusterer, Lucia Stäubli, Nina Streeck.
Oxford: Oxford University Press 2015.
This book discusses the patient’s wish to die in context of different research methodologies about patients’ wishes at the end-of-life, together with a series of ethical views on the clinical implications for palliative care. It presents material in an open and unbiased manner whilst remaining sensitive to the spiritual and existential dimensions of dying, and to the different cultural views that provide meaning to the individual.
• Provides an up-to-date review of the state of knowledge in international end-of-life research
• Empirical, ethical, and clinical perspectives help readers understand the patients’ wishes to die from relevant perspectives, including the patients’
• Offers a cross-disciplinary understanding and collaboration in end-of-life topics
• Dialogue sections help the understanding of academic chapters.