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Abstract：
The expressions of a \"wish to hasten death\" or \"wish to die\" raise ethical concerns and challenges. These expressions are related to ethical principles intertwined within the field of medical ethics, particularly in end-of-life care. Although some reviews were conducted about this topic, none of them provides an in-depth analysis of the meanings behind the \"wish to hasten death/die\" based specifically on the ethical principles of autonomy, dignity, and vulnerability. The aim of this review is to understand if and how the meanings behind the \"wish to hasten death/die\" relate to and are interpreted in light of ethical principles in palliative care.
We conducted a meta-ethnographic review according to the PRISMA guidelines and aligned with Noblit and Hare\'s framework. Searches were performed in three databases, Web of Science, PubMed, CINAHL, with no time restrictions. Original qualitative studies exploring the meanings given by patients, family caregivers and healthcare professionals in any context of palliative and end-of-life care were included. A narrative synthesis was undertaken. PROSPERO registration CRD42023360330.
Out of 893 retrieved articles, 26 were included in the analysis, accounting for the meanings of a total of 2,398 participants. Several factors and meanings associated with the \"wish to hasten death\" and/or \"wish to die\" were identified and are mainly of a psychosocial and spiritual nature. The ethical principles of autonomy and dignity were the ones mostly associated with the \"wish to hasten death\". Ethical principles were essentially inferred from the content of included articles, although not explicitly stated as bioethical principles.
This meta-ethnographic review shows a reduced number of qualitative studies on the \"wish to hasten death\" and/or \"wish to die\" explicitly stating ethical principles. This suggests a lack of bioethical reflection and reasoning in the empirical end-of-life literature and a lack of embedded ethics in clinical practice. There is a need for healthcare professionals to address these topics compassionately and ethically, taking into account the unique perspectives of patients and family members. More qualitative studies on the meanings behind a wish to hasten death, their ethical contours, ethical reasoning, and implications for clinical practice are needed.
We conducted a meta-ethnographic review according to the PRISMA guidelines and aligned with Noblit and Hare\'s framework. Searches were performed in three databases, Web of Science, PubMed, CINAHL, with no time restrictions. Original qualitative studies exploring the meanings given by patients, family caregivers and healthcare professionals in any context of palliative and end-of-life care were included. A narrative synthesis was undertaken. PROSPERO registration CRD42023360330.
Out of 893 retrieved articles, 26 were included in the analysis, accounting for the meanings of a total of 2,398 participants. Several factors and meanings associated with the \"wish to hasten death\" and/or \"wish to die\" were identified and are mainly of a psychosocial and spiritual nature. The ethical principles of autonomy and dignity were the ones mostly associated with the \"wish to hasten death\". Ethical principles were essentially inferred from the content of included articles, although not explicitly stated as bioethical principles.
This meta-ethnographic review shows a reduced number of qualitative studies on the \"wish to hasten death\" and/or \"wish to die\" explicitly stating ethical principles. This suggests a lack of bioethical reflection and reasoning in the empirical end-of-life literature and a lack of embedded ethics in clinical practice. There is a need for healthcare professionals to address these topics compassionately and ethically, taking into account the unique perspectives of patients and family members. More qualitative studies on the meanings behind a wish to hasten death, their ethical contours, ethical reasoning, and implications for clinical practice are needed.
摘要：
“希望加速死亡”或“希望死亡”的表达引起了道德上的关注和挑战。这些表达与医学伦理学领域中交织在一起的伦理原则有关，尤其是临终关怀。尽管对此主题进行了一些评论，他们都没有根据自治的道德原则对“希望加速死亡/死亡”背后的含义进行深入分析，尊严,和脆弱性。这篇评论的目的是了解“希望加速死亡/死亡”背后的含义是否以及如何与姑息治疗中的伦理原则相关并加以解释。
我们根据PRISMA指南进行了元人种学审查，并与Noblet和Hare的框架保持一致。在三个数据库中进行搜索，WebofScience,PubMed,CINAHL,没有时间限制。原始的定性研究探索患者赋予的含义，包括任何姑息治疗和临终关怀的家庭护理人员和医疗保健专业人员.进行了叙事综合。PROSPERO注册CRD42023360330。
在检索到的893篇文章中，分析中包括26个，占2,398名参与者的含义。确定了与“希望加速死亡”和/或“希望死亡”相关的几个因素和含义，这些因素和含义主要具有心理社会和精神性质。自治和尊严的道德原则主要与“加速死亡的愿望”有关。伦理原则基本上是从收录文章的内容中推断出来的，虽然没有明确规定为生物伦理原则。
本元人种学综述显示，关于“希望加速死亡”和/或“希望死亡”的定性研究数量减少，这些研究明确指出了伦理原则。这表明在经验性的生命终结文献中缺乏生物伦理学的反思和推理，并且在临床实践中缺乏嵌入式伦理学。医疗保健专业人员需要富有同情心和道德地解决这些问题，考虑到患者和家庭成员的独特视角。对加速死亡的愿望背后的含义进行了更多的定性研究，他们的伦理轮廓，伦理推理，和临床实践的影响是必要的。
我们根据PRISMA指南进行了元人种学审查，并与Noblet和Hare的框架保持一致。在三个数据库中进行搜索，WebofScience,PubMed,CINAHL,没有时间限制。原始的定性研究探索患者赋予的含义，包括任何姑息治疗和临终关怀的家庭护理人员和医疗保健专业人员.进行了叙事综合。PROSPERO注册CRD42023360330。
在检索到的893篇文章中，分析中包括26个，占2,398名参与者的含义。确定了与“希望加速死亡”和/或“希望死亡”相关的几个因素和含义，这些因素和含义主要具有心理社会和精神性质。自治和尊严的道德原则主要与“加速死亡的愿望”有关。伦理原则基本上是从收录文章的内容中推断出来的，虽然没有明确规定为生物伦理原则。
本元人种学综述显示，关于“希望加速死亡”和/或“希望死亡”的定性研究数量减少，这些研究明确指出了伦理原则。这表明在经验性的生命终结文献中缺乏生物伦理学的反思和推理，并且在临床实践中缺乏嵌入式伦理学。医疗保健专业人员需要富有同情心和道德地解决这些问题，考虑到患者和家庭成员的独特视角。对加速死亡的愿望背后的含义进行了更多的定性研究，他们的伦理轮廓，伦理推理，和临床实践的影响是必要的。
