Autolytic ideation at the end-of-life in palliative oncological patients: Case report

The development of the illness in oncology patients produces a series of uncomfortable and frequently annoying symptoms that can cause significant psychological distress in both patients and their relatives. Under these circumstances, the patients can experience autolytic ideation, even when acceptable symptomatic controls are in place. This situation is of great complexity and of difficult handling both for the family and for the medical care team as they have to deal with various ethical, moral, spiritual and legal questions. These aspects can be complementary to existing ones, but others will not be. This situation can conflict with the principle of autonomy of the patient, in the sense that his/her personal desires may compromise or even jeopardize the action plan of the medical team that looks after the patient. In this clinical note, we share the experience lived in our service regarding a patient with the idea of committing suicide and the actions that were carried out. Finally, some recommendations agreed with lawyers and experts in Bioethics are suggested.