B. Rosenfeld et al., Measuring desire for death among patients with HIV/AIDS: The schedule of attitudes toward hastened death, AM J PSYCHI, 156(1), 1999, pp. 94-100
Objective: As physician-assisted suicide is debated, a need for standardize
d measurement of desire for death among medically ill individuals has emerg
ed. The authors present preliminary validation data for a new self-report i
nstrument, the Schedule of Attitudes Toward Hastened Death. Method: The par
ticipants were 195 patients with HIV/AIDS from two sites: 148 ambulatory pa
tients and 47 patients who had been recently admitted to a facility for end
-of-life care. The ambulatory participants completed the 20-item Schedule o
f Attitudes Toward Hastened Death and several other instruments, including
the Beck Depression Inventory and Brief Symptom Inventory. The terminally i
ll patients also completed the Schedule of Attitudes Toward Hastened Death,
along with other measures, and were assessed by clinicians with the Hamilt
on Depression Rating Scale and the Desire for Death Rating Scale, a global
clinician rating of the patient's desire for death. Results: The Schedule o
f Attitudes Toward Hastened Death demonstrated high reliability. The total
score significantly correlated with the clinician rating on the Desire for
Death Rating Scale and with ratings of depression and psychological distres
s. In addition, the Schedule of Attitudes Toward Hastened Death score signi
ficantly correlated with pain intensity and physical symptom distress. Fact
or analysis supported a single factor structure for the instrument. Conclus
ions: These results indicate that the Schedule of Attitudes Toward Hastened
Death is a reliable, valid measure of desire for death among patients with
HIV/AIDS. Further research with this measure may help address many of the
unanswered questions emerging from the ongoing debates regarding legalizati
on of assisted suicide.