Objectives

1.
Identify terms used to describe assisted suicide in Washington state home hospice services.
2.
Evaluate impact of culture and location on interpretation of experiences of patients’ suicide and hastened death in hospice care.
3.
Provide recommendations for professionals to address concerns about suicide and hastened death in home hospice care where assisted suicide legislation has been enacted.


Methods

A qualitative study using semi-structured interviews has been undertaken in a US state where physicians are legally able to prescribe a lethal dose of medications for mentally competent patients who request them. Professionals were interviewed about their experiences with patients who died by suicide, interpretations of suicide and hastened death and how this influences work with home hospice patients. A thematic analysis using a social constructionist framework influenced by Foucault’s theory of knowledge and power is used to analyse the data.

Results

Twenty-one hospice professionals (4 physicians, 7 nurses, 7 social workers, 3 chaplains) participated in the study. Initial analysis has identified blurry boundaries, challenges and barriers with access to options to relieve pain and symptoms. Interpretation of suicide and hastened death is affected by culture, faith, and perception of organizational policy. Experiences with patients who died by suicide vary depending on location and access to services.

Conclusions

Interpretations of suicide and language of the law impacts professionals’ experiences with patients expressing desire for hastened death.