Mental health-related, existential, and biological factors are associated with the desire to hasten death in Mexican cancer patients undergoing palliative care: A single-center study
Bibliographic record
Abstract
INTRODUCTION: The wish to hasten death (WTHD) is a clinically significant phenomenon that arises from complex suffering. It has been predominantly studied in Caucasian populations, emphasizing the importance of gaining more diverse cultural perspectives. This study explores the factors associated with the WTHD in Mexican cancer patients receiving palliative care from one academic center, with a specific focus on its connection to dignity.". PATIENTS AND METHODS: The study, a cross-sectional research conducted between October 12, 2023, and August 30, 2024, involved patients with confirmed cancer diagnoses who were attending a palliative care service. Patients had applied the Patient Dignity Inventory (PDI), Schedule of Attitudes Toward Hastened Death (SAHD), Brief Edinburgh Depression Scale (BEDS), EORTC QLQ-C15-PAL to assess health-related quality of life, Karnofsky Performance Status Scale (KPSS) to assess functional capacity, and the Edmonton Symptom Assessment System. A PDI score ≥55 indicated a fractured sense of dignity (DPD), while a SAHD score ≥1 indicated the WTHD. Factors associated with the WTHD were identified using multiple logistic regression analysis. The study was approved by the IRB. RESULTS: The study included 302 primarily middle-aged (54.5 [45-64]) females (225 [74.5%]), with 9 years of education. They reported high severity of well-being (7 [1-7]) and tiredness (3 [0-6]). Their median KPSS score showed independence (80 [70-80]), despite impacts across all EORTC QLQ-C15-PAL dimensions. DPD was noted in 110 patients (36.5%). The most frequent diagnoses were breast cancer (114 [38%]), lung cancer (33 [11%]), and gastrointestinal cancer (28 [9%]). The WTHD was found in 94 patients (31.1%). Factors significantly associated included tiredness score (OR: 1.147, 95% CI: 1.044-1.261, p = 0.004), BEDS score (1.181, 1.085-1.284, p ≤ 0.001) and a DPD (1.979, 1.038-3.772, p = 0.04). CONCLUSIONS: The WTHD was found in one out of every three Mexican cancer patients receiving palliative care and was linked to biological-, mental health-, and existential-related factors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".