Nurses knowledge and attitudes about euthanasia at national and international level: A review of the literature

[PAL-PRAT study: Healthcare workers' knowledge and perception of palliative practices in a Cancer Center]

INTRODUCTION

The issue of end-of-life care is the subject of a sensitive debate in French society, particularly regarding the possibility for certain patients to have access to medical assistance in dying. The aim of this study was to assess the knowledge and opinion of healthcare providers on the care practices for patients at the end of life, as well as to highlight any specificities in their discourse.

METHOD

A survey of healthcare providers' opinions, composed of closed and open questions, that were analyzed using a lexicometric approach, was distributed in a cancer center.

RESULTS

The results of the study reveal a good knowledge of the different procedures. Professionals considered that advance directives should be systematically collected; a majority of them differentiated euthanasia from deep continuous sedation and perceived the latter as a means of relieving patients' suffering without inducing death. The different procedures related to the active assistance in dying were known by a majority of professionals and the survey did not identify a dominant trend concerning the will to practice euthanasia if the legal framework allowed it. Half of the participants considered their training insufficient, indicating the need to fill this gap.

DISCUSSION

This survey underlines the importance of training and support for the professionals caring for patients in palliative situation and their relatives in France.

Nursing students' attitude toward euthanasia following its legalization in Spain

BACKGROUND

Euthanasia is a controversial practice in many countries. Since Spain's Euthanasia Law came into effect on March 24, 2021, healthcare providers have faced a new challenge since they must inform patients, provide care, accompany them, and implement the law. It also represents a new stumbling block at universities, which must adapt to regulatory changes and educate future professionals accordingly. Little is known about the attitude of nursing students in Spain toward euthanasia since this law was implemented.

OBJECTIVE

This study aims to answer the following research questions: What is the attitude of nursing students toward euthanasia? What factors influence this attitude?

RESEARCH DESIGN

A cross-sectional study was conducted using an online questionnaire.

PARTICIPANTS AND RESEARCH CONTEXT

The study population comprised all nursing students at a public university in Barcelona (n = 444), Spain, during the 2022-2023 academic year. The validated Spanish version of the Euthanasia Attitude Scale was employed. A bivariate analysis was performed.

ETHICAL CONSIDERATIONS

The university Ethics Committee (CEEAH 6247) approved this study. All participating students signed an informed consent form. Participation was voluntary, and data anonymity and confidentiality were guaranteed.

RESULTS

Two hundred and forty-four nursing students responded to the questionnaire. The mean total score was 79.64. Participants with religious beliefs presented lower scores, indicating a more negative attitude toward euthanasia. Participants in their second, third, or fourth year of the nursing degree scored higher, demonstrating a more positive attitude.

CONCLUSIONS

The attitude of nursing students toward euthanasia was remarkably positive. Working on ethical content during the degree course and clinical practice are factors that help to develop a more positive attitude. In addition, nursing education should encourage professional aspects to prevail over religious beliefs in euthanasia situations.

The paradoxical position of nurses regarding euthanasia and its legalisation: A descriptive quantitative study

AIMS AND OBJECTIVES

To learn about the attitudes of nurses working in the Andalusian Public Health System regarding euthanasia and its legalisation.

BACKGROUND

Euthanasia often finds itself in the crosshairs of ethical and political debate on an international scale. Currently, the Spanish Organic Law 3/2021 of 24 March, 2021, recognises euthanasia as a fundamental right in Spain. It is of particular interest to know about the views, attitudes and stances that Andalusian nurses have of euthanasia as they are key players within the framework of euthanasia and administration of life-ending drugs. They play a central role in guiding patients through the euthanasia application process.

DESIGN

Observational descriptive study.

METHODS

A study of Andalusian Public Health System nurses was carried out using non-probability convenience sampling. 518 nurses with an average age of 44.75 years answered in a questionnaire that was distributed on an online platform. Socio-demographic and occupational variables were assessed, together with the Death Anxiety Scale and the Euthanasia Attitude Scale. A bivariate analysis and a multivariate linear regression model were performed. The STROBE checklist was used.

RESULTS

The mean score obtained on the Euthanasia Attitude Scale was 75.95 (SD = 16.53). The mean score obtained on the Death Anxiety Scale was 7.56 (SD = 3.05). The variables age and work experience were negatively correlated with the total scores of the Euthanasia Attitude Scale and the categories 'Ethical considerations', 'Practical considerations' and 'Treasuring life'. On the other hand, there was a significant positive correlation between age and work experience and 'Spiritual beliefs' category.

CONCLUSIONS

The current situation shows a worrying paradox. There is a stark difference between positive professional attitudes towards euthanasia and the desire to participate in its application.

RELEVANCE TO CLINICAL PRACTICE

It is vital that educational and healthcare institutions make the necessary efforts to ensure that nurses develop sound moral judgement, displaying the moral conscience and ethical commitment required of this established profession.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Knowledge and attitudes toward euthanasia among final year pharmacy and law students: a cross-sectional study

BACKGROUND

Euthanasia is the last resort for those living with untreatable and terminable diseases which cause pain and suffering. However, the concept of euthanasia resulted in many dilemmas and controversy around life extension and death.

OBJECTIVE

The aim of this study was to evaluate the knowledge and attitudes of final year pharmacy and law students concerning euthanasia.

METHODS

A descriptive cross-sectional study was carried out among all final year law and pharmacy undergraduate students. The data were collected using self-administered structured questionnaire and analyzed by SPSS version 22. Multivariate logistic regression was used to assess the influence of socio-demographic characteristics of participant's on acceptance of euthanasia.

RESULT

72 (61.5%) of the students were declared that euthanasia is administration of lethal drugs to a patient at the explicit request of that patient. Majority 87 (74.4%) of the students knew that euthanasia is active shortening of the dying process. Most participants 95(81.2%) awared that there is no legalized euthanasia in Ethiopia. On the other hand, 47(40.2%) believed the patient has the right to choose to end his/her own life. Around 45% had the view that euthanasia should be legalized in some circumstances. Only 27.3% (n = 32) of the respondents endorsed legalization of euthanasia in Ethiopia. 35 (29.9%) said euthanasia should be performed. The acceptance of euthanasia was greater for pharmacy students compared to law students [adjusted odds ratio (AOR) = 3.490; 95% CI 1.346-9.049; p = 0.010] and lower for Muslim students compared to Orthodox students (AOR = 0.186; 95% CI 0.044-0.783; p = 0.022).

CONCLUSION

The final year law and pharmacy students were aware of euthanasia. However, majority of students did not reveal favorable attitude toward euthanasia and its acceptance was low. Participants' field of study and religion were significantly affect acceptance of euthanasia As the current study limited to pharmacy and law students, the authors suggest that future studies should involve various segments of societies to investigate more about euthanasia in Ethiopia.

Analysis of Factors Influencing Polish Students' Opinions on Euthanasia

Due to the continuous development of palliative care and methods of pain relief in the last moments of patients’ lives, we are faced with the question of how long we should take measures to delay inevitable death for, without providing prolonged therapy against the patient’s will. For terminally ill and people experiencing unimaginable suffering, euthanasia is considered as one of the possible options for a dignified farewell. The aim of the study was to determine the views on euthanasia in a group of students from Polish universities. Questionnaire responses were analyzed for 9686 students (79.9% of women and 20.1% of men) aged 18−35 years. Respondents were asked to complete their own questionnaire on demographic data and attitudes toward euthanasia in the case of severe terminal illness or paralysis preventing independent living. Euthanasia was significantly more acceptable among women (85% vs. 75%, p < 0.0001; 69% vs. 62%, p < 0.0001) and non-believers [98% vs. 97% (denominations other than Christian), 84% (other forms of Christianity), 69% (Roman Catholic); p < 0.0001] in every case considered. Religious affiliation was the factor that most influenced attitudes toward euthanasia. Among the other elements influencing attitudes toward euthanasia, residence and field of study were distinguished. Considering the large sample size and specific conclusions, the article should be an important argument in the discussion on euthanasia.