Origins of the desire for euthanasia and assisted suicide in people with HIV-1 or AIDS: a qualitative study

Background Euthanasia and assisted suicide, and policies to address them ar e the subjects of contentious debate in many countries. However, the questi on of why people desire euthanasia or assisted suicide has not been coheren tly answered. We aimed to answer this question in a specific group of patie nts. Methods We did a qualitative study of 32 people with HIV-1 or AIDS, who wer e enrolled in the HIV-1 Ontario Observational Database at Sunnybrook and Wo men's College Health Sciences Centre, Toronto, Ontario, Canada. We elicited participants' experiences of deliberation about euthanasia or assisted sui cide, and the meaning of these experiences with in-depth, face-to-face inte rviews. We analysed our data with grounded theory methods. Findings Participants' desire for euthanasia and assisted suicide were affe cted by two main factors: disintegration, which resulted from symptoms and loss of function; and loss of community, which we defined as progressive di minishment of opportunities to initiate and maintain close personal relatio nships. These factors resulted in perceived loss of self. Euthanasia and as sisted suicide were seen by participants as means of limiting loss of self. Interpretation These determinants of desire for euthanasia or assisted suic ide in people with HIV-1 or AIDS have implications for the debate on these practices, and development of policies to regulate them.