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En la sociedad occidental, el debate sobre el suicidio médicamente asistido (SMA) o la eutanasia en pacientes con enfermedad avanzada se centra, frecuentemente, en aspectos éticos o legales y olvida los motivos por los que un paciente puede desear adelantar su muerte.
La etiología del deseo de adelantar la muerte (DAM) es compleja y multifactorial. Estudios cualitativos muestran que la expresión del DAM tiene, para el paciente, diferentes significados que no implican necesariamente el deseo de acelerar la propia muerte. Según esto, el DAM aparecería en respuesta a un malestar emocional abrumador, consecuencia de un sufrimiento multidimensional secundario a las diferentes pérdidas producidas por la enfermedad —entre las que estaría la pérdida de sentido de la vida y el miedo a proceso natural de morir.
La identificación del DAM como fenómeno reactivo al sufrimiento llama la atención sobre la necesidad de desarrollar planes de cuidados tendentes a prevenirlo, detectarlo y tratarlo. Algunas características del DAM, como su variabilidad temporal, la necesidad de descartar un estado depresivo concomitante a la enfermedad del paciente, así como identificación del DAM como respuesta al sufrimiento, más que afirmación de la propia identidad o deseo de autodeterminación del paciente, hablarían en contra de facilitar el SMA.
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