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Research Digest

November 8, 1999
Desire to Live in Terminally Ill Patients Fluctuates Daily

We 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.

Warmly, lillian
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