Kerstin Kremeike

Marjana Bernot




Kerstin Kremeike


Centre for Palliative Medicine, University Hospital Cologne








Attitudes towards proactively addressing desire to die in patients in their last months of life across Europe


The updated version of the German evidenced-based guideline on palliative care for patients with incurable cancer proposes health professionals to proactively addressing desire to die (DD). DD is frequent in patients in their last months of life. It can be understood as a broad phenomenon ranging from being tired of life and the acceptance of death to the wish for hasted death (WTHD) and even acute suicidality. So far, little research on proactively addressing DD has been carried out.
At our Centre for Palliative Medicine at the University Hospital Cologne, Germany, we have shown that DD can be proactively addressed for research purposes and developed a DD communication guideline for everyday clinical practice. However, in light of physician-assisted suicide legislation, health practitioners report insecurities in dealing with DD.



To make a contribution to the European debate on (proactively) addressing DD through collecting and publishing viewpoints concerning the topic from five different European countries.


Methods / process

We plan to query two experts each (clinician/researcher and ethicist/politician) in five European countries with different legislation (Belgium, England, Germany, Poland, and Spain). By semi- structured qualitative face to face or telephone interviews attitudes towards proactively addressing DD will be assessed. Methodologically qualitative content analysis will be applied to the interview data thus generated.


Intended outputs / impact

Research results will help us to better understand European positions towards our view of proactively addressing DD to be the best practice in dealing with the phenomenon in the spectrum of European attitudes towards DD and physician-assisted suicide.
Results will be published in an international Open Access journal. Cross-cultural understanding and international discourse about a central issue in palliative care can thus be deepened.