Research Digest November 8, 1999 Desire to Live in Terminally Ill Patients Fluctuates
often hear about the importance of a "will to live" among patients with
devastating illnesses. Now a recent study, published in "The Lancet," reports
that a willingness to keep on living fluctuates wildly among individuals with
terminal cancer, even when measured twice on the same day, not to mention from
day to day or from week to week.
Researchers at the University of Manitoba in Winnipeg, Canada, studied
168 terminal cancer patients, ages 31 to 89, in a palliative care unit. Twice a
day, these patients indicated on a scale of zero to 100 where they stood on a
number of items, including depression, anxiety, sense of well-being, difficulty
breathing, pain, will to live, and so forth.
For some individuals, scores on the "will to live" item
changed an average of 30 points in just a 12-hour period. Some patients marked
zero at one time and 100 at another time on the same day.
Depression, anxiety, difficulty in breathing,
and sense of well-being each had a strong influence on will to live.
Furthermore, as patients neared death, physical symptoms such as breathlessness
and lack of well-being had a greater influence on their will to live than
emotions, such as depression and anxiety.
The researchers point out that the findings in this study
can't be applied to all patients with terminal illnesses; these patients were
mostly elderly and all had terminal cancer. Younger patients or those with other
kinds of diseases might react quite differently.
Still, the authors point out, a patient's state
of mind should be the most important factor in evaluating requests for assisted
suicide. Given these results, it's important to make sure that a patient's
wishes are discussed over a period of time, not just once.