Statement of the Problem: The Desire for Hastened Death (DHD) is a complex issue that can be influenced by a variety of factors, including depression. DHD is often viewed as a reaction to suffering, and it is important to assess and understand this construct to help patients with advanced cancers cope and find meaning in their lives. This study identified factors associated with DHD in patients with advanced cancers. Methodology & Theoretical Orientation: A sequential mixed-methods cross-sectional study conducted among 106 adult outpatients with advanced cancer awaiting enrolment in palliative care in Nigeria. They were first assessed quantitatively for DHD using the Schedule of Attitude towards Hastened Death (SAHD), which was followed by in-depth interviews to qualitatively explore DHD. T-test statistics were used to determine the factors associated with DHD, while the significant predictors were analyzed using a multivariable linear regression model.

Findings: 12⸱3% participants had high DHD based on a SAHD score of ≥10. Depression (β = 0.07, p = 0.013), Income (β = 1.21, p = 0.010) and Religiosity (β = 1.28, p = 0.010) were significant predictors of DHD. A high DHD was transient for most study participants who used it to communicate gross dissatisfaction in physical functioning, clinical service delivery, or treatment outcomes. Religion played a major role in the explanatory model of illness in this patient group. It was a recurring theme in the coping methods utilized by patients and their causal attribution of cancer diagnosis to spiritual attack.

Conclusion & Significance: DHD is common in patients with advanced cancer awaiting enrolment into palliative care. It can be transient and amenable to system-wide changes in cancer treatment in resource-poor settings. Furthermore, wellness may be promoted in this group of at-risk individuals through routine assessment of DHD and provision of culturally sensitive psychosocial support.  

Agboola Adigun is a General Adult Psychiatrist and Fellow of the West African College of Physicians. He holds two professional masters degrees and is currently based in Aberdeen, UK, pursuing a Clinical Fellowship with NHS Scotland. In his 18years as a physician, he has developed a passion for dealing with some of the more demanding patient categories. As an example, for his dissertation, he explored a desire for hastened death in patients with advanced cancers. He recognizes the value inherent in timely psychological support for patients with cancer notwithstanding prognostic limitations. His passion for supporting holistic cancer treatment developed as a consequence of his personal experience, with two close relatives diagnosed with terminal cancers at the same time.