Background:
Cancer deeply affects patients and places a heavy burden on family caregivers. As suffering increases, limited end-of-life options and lack of support may lead to tragic outcomes like homicide-suicides. In Taiwan, the 2019 Patient Right to Autonomy Act allows refusal of life-sustaining treatment, but euthanasia remains illegal. This study examines such cases, exploring links to long-term care, patient autonomy, and social support.
Objectives:
This study investigates the interaction between cancer patients suffering and caregivers psychological and physical burden, analyzing how systemic resource inadequacies may contribute to tragedy. Using real-life Taiwanese cases, it examines patient and caregiver situations amid underdeveloped end-of-life care policies and support systems.
Methodology:
A qualitative case analysis was conducted on two recent murder suicide cases involving cancer patients in Taiwan. Thematic content analysis focused on patient suffering, caregiver psychological stress, medical and social resource use, family finances, and patient decision making autonomy.
Results:
Both cases involved patients in severe physical and emotional pain, with no clear evidence of advance care planning or palliative care. Caregivers faced intense psychological and financial strain, ultimately viewing their actions as a last resort framed as an act of “release” or “compassion.” These cases reveal social risks tied to limited understanding of end-of-life options and inadequate caregiver support.
Conclusion:
This study highlights the need to address the suffering of cancer patients and the burden on caregivers. Although palliative care in Taiwan is well established, it is often misunderstood as "waiting to die," causing emotional conflict for patients who suffer yet wish for death. Greater public education is needed to change these perceptions. Strengthening caregiver support and encouraging open discussions on patient autonomy and end-of-life choices alongside integrated care and legal frameworks may help prevent similar tragedies and improve quality of life.
Keywords: patients suffering, caregiver burden, end-of-life care, patient autonomy