End of Life Issues in Patients with AIDS: Clinical and Research Considerations

Abstract

This paper examines some clinical and research considerations that are important in understanding end of life issues in patients with AIDS. Pain and other medical symptoms, neuropsychiatric complications and psychosocial factors are discussed that impact upon the views such patients may have of palliative care, physician-assisted suicide, euthanasia and the desire to hasten death. The importance of increasing physicians' ability to diagnose and treat depression, anxiety, organic mental syndromes, pain and other distressing symptoms is stressed. The possible impact that such treatment may have on obviating the desire to hasten death that stems from unrecognized suffering is discussed. The great social diversity of the AIDS population, and the challenge it poses to palliative care specialists, and a number of social factors that affect end of life issues in our clinical experience and research are described.