Measuring desire for death among patients with HIV/AIDS: The schedule of attitudes toward hastened death

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.