Background
The desire for medical assistance in dying (MAiD) ranges from 2.5-10% in patients with advanced cancer. This study describes the relationship of distress variables to MAiD interest.
Methods
Descriptive data are presented from a longitudinal study on the desire for MAiD in patients with advanced cancer. The sample comprised 330 patients at baseline and 44 that requested MAiD, of which 16 received MAiD. Pearson correlations were calculated between the Wish to Hasten Death (SAHD-A), Will to Live Scale (WTLS), Death and Dying Distress Scale (DADDS), Self Perceived Burden Scale (SPBS), Patient Health Questionnaire-9 (PHQ-9) depression scale, and Edmonton Symptom Assessment Scale-revised (ESAS-r) symptom burden.
Results
Prevalence of high SAHD-A and DADDS: Across categories from no MAiD interest (2.4%, 33%) to MAiD request but died naturally (18%, 45%) and MAiD receipt (21%, 27%). Mean WTLS remained high across all groups. The DADDS was significantly positively correlated (p ≤ 0.01) with SPBS (r = 0.425), PHQ-9 (r = 0.527), and ESAS-r (r = 0.547) in those with no MAiD interest. Among MAiD requestors, DADDS correlated with only SPBS (r = 0.572).
Conclusions
The wish to hasten death remains low in most patients who request and complete MAiD, while the will to live remains high. Death anxiety is highest in patients who request, but do not receive MAiD. Death anxiety is associated with multiple types of distress among individuals not requesting MAiD, but only self-perceived burden among MAiD requester. There are many psychological states within MAiD interest potentially amenable to psychosocial interventions.