School of Interdisciplinary Studies, Dumfries Campus, University of Glasgow, Dumfries, Scotland, DG1 4ZL, UK.
Division of Health Research, Lancaster University, Lancaster, UK.
BMC Palliat Care. 2019 Aug 31;18(1):75. doi: 10.1186/s12904-019-0451-4.
Laws allowing assisted suicide and euthanasia have been implemented in many locations around the world but some individuals suffering with terminal illness receiving palliative care services are hastening death or die by suicide without assistance. This systematic review aims to summarise evidence of palliative care professionals' experiences of patients who died by suicide or hastened death in areas where assisted dying is legal and to understand when hastened death is considered to be a suicide.
AMED, CINAHL Complete, PsycINFO, PubMED, and Academic Search Ultimate were searched for articles from inception through June 2018. Quality assessment used the Hawker framework.
A total of 1518 titles were screened resulting in thirty studies meeting eligibility criteria for this review. Published studies about professionals' experiences from areas with legalised assisted dying includes limited information about patients who hasten death outside legal guidelines, die by suicide without assistance, or if the law impacts suicide among palliative care patients.
There are a range of experiences and emotions professionals' experience with patients who die by euthanasia, assisted suicide, or hasten death without assistance. The included literature suggests improved communication among professionals is needed but does not explicitly identify when a hastened death is deemed a suicide in areas where assisted dying is practiced. More research is needed to help clarify what hastened death means in a palliative care context and identify how and if assisted dying impacts issues of suicide in palliative care settings.
允许协助自杀和安乐死的法律已在世界许多地方实施，但一些接受姑息治疗服务的终末期疾病患者在没有协助的情况下加速死亡或自杀。本系统评价旨在总结姑息治疗专业人员在协助自杀合法地区对自杀或加速死亡患者的经验，并了解何时加速死亡被视为自杀。
从成立到 2018 年 6 月，在 AMED、CINAHL Complete、PsycINFO、PubMED 和 Academic Search Ultimate 中搜索文章。使用 Hawker 框架进行质量评估。
共筛选出 1518 个标题，最终有 30 项研究符合本综述的纳入标准。关于在合法化协助死亡地区专业人员经验的已发表研究仅包含有限的关于不符合法律指南加速死亡、未经协助自杀或法律是否影响姑息治疗患者自杀的患者的信息。
姑息治疗专业人员在协助安乐死、协助自杀或未经协助加速死亡的患者方面存在各种不同的经验和情绪。所纳入的文献表明，需要改善专业人员之间的沟通，但并未明确指出在协助自杀实施的地区，何时加速死亡被视为自杀。需要进一步研究来帮助澄清在姑息治疗背景下加速死亡的含义，并确定协助自杀如何以及是否影响姑息治疗环境中的自杀问题。
