Presentation (CTI)

OBJECTIVES: In Colombia, a pioneering Latin American country in decriminalizing euthanasia, evidence regarding requests within oncology populations remains scarce. This scarcity limits the optimization of palliative and end-of-life care programs. This study aims to describe the sociodemographic and clinical variables of cancer patients requesting euthanasia and to identify the specific dimensions of suffering driving these requests.
METHODS: This retrospective, observational study evaluated adult patients (≥18 years of age) with a confirmed cancer diagnosis who requested euthanasia at an oncology clinic in Medellin, Colombia, between January 2024 and December 2025. Patients without a formal psychiatric evaluation were excluded. Data were extracted from electronic health records. Suffering was categorized into four dimensions: physical (pain, dyspnea, insomnia, loss of mobility, visual or auditory impairment, nausea, dizziness, and dependence), psychological (fear, anger, sadness, worthlessness, and grief), social (loneliness, disruption of social networks, and loss of meaningful social roles), and existential (hopelessness and conflicts regarding personal values, perceptions, expectations, or the future). Descriptive statistics were used to summarize the data.
RESULTS: A total of 152 patients were analyzed (median age 61.6 years [IQR: 52.0-72.0]; 56.6% male). Most patients identified as Catholic (78.9%). Gastrointestinal tumors were the most frequent primary malignancy (40.8%, n=62). Most patients had metastatic disease (91.4%) and poor performance status (85.6% with an ECOG ≥2). Notably, 92.8% received specialized palliative care, and 80.9% utilized third-tier analgesia. When evaluating the motives driving these requests, physical suffering was the predominant dimension (88.2%), followed by existential (43.4%), psychological (25.7%), and social (7.9%) dimensions. Only 33.6% of patients had signed advance directives.
CONCLUSIONS: While physical suffering is the primary motivation for euthanasia requests, psychological, social, and existential dimensions are also fundamental drivers. Optimizing end-of-life care requires strengthening integrated, multidisciplinary strategies to effectively address the multidimensional suffering experienced by cancer patients throughout the disease trajectory.