Principles for the discussion of life and death options with terminally ill clients with HIV

Professional psychologists will increasingly have a role in discussing life-and-death options for terminally ill patients. Under certain circumstances, the desire to hasten one's death may be viewed as legitimate. The authors suggest principles for clinical discussion with terminally ill clients with HIV and outline a decision process to assist in determining whether a client's wish to die is well reasoned and that all alternatives have been considered. The authors describe a collaborative decision-making model for use in discussing life-and-death decisions and lay out a series of principles to guide therapist-client discussion of this very difficult decision.