Euthanasia and palliative psychology in end-of-life care

A Challenge for Palliative Psychology: Freedom of Choice at the End of Life among the Attitudes of Physicians and Nurses

This article considers a particular aspect of palliative psychology that is inherent to the needs in the area of attitudes concerning Advance Healthcare Directives (AHDs) among Italian physicians and nurses after the promulgation of Law No. 219/2017 on AHDs and informed consent in 2018. The study utilized a mixed-method approach. The group of participants was composed of 102 healthcare professionals (63 females and 39 males). The quantitative part utilized the following scales: Attitudes toward Euthanasia, the Religious Orientation Scale, the Balanced Inventory of Desirable Responding, and the Testoni Death Representation Scale. The results were mostly in line with the current literature, especially concerning a positive correlation between religiosity and the participants’ rejection of the idea of euthanasia. However, the qualitative results showed both positive and negative attitudes towards AHDs, with four main thematic areas: “Positive aspects of the new law and of AHDs”, “Negative aspects of the new law and of AHDs”, “Changes that occurred in the professional context and critical incidents”, and “Attitudes towards euthanasia requests.” It emerged that there is not any polarization between Catholics or religious people and secularists: Their positions are substantially similar with respect to all aspects, including with regard to euthanasia. The general result is that the law is not sufficiently understood, and so a quarter of the participants associate AHDs with euthanasia. Discussions on the opportunity for palliative psychologists to help health professionals to better manage these issues through death education courses are presented.

The Psychology of Euthanasia

Abstract. Voluntary euthanasia has been legalized in several countries and associated with this development there has been much discussion concerning the relationship between the ethical principle of autonomy and the respect for human life. Psychological science should make a significant contribution to understanding how polarizing positions may be taken in such debates. However, little has been written concerning the implications of this research for the euthanasia debate and about the contributions of psychology. In the same way, very little is written about the psychologist’s role in countries where voluntary euthanasia or assisted suicide is legalized. We take as a starting assumption that there are no solutions that will meet everyone’s wishes or needs, but that an understanding of psychological ideas, can assist in developing strategies that may help people with opposing views come to some agreement. In our view, it is fundamental to a fruitful analysis, to leave aside a polarized approach and to understand that an eventual answer to the question of how we approach voluntary euthanasia will only be achieved after the hard process of carefully considering the consequences of having either legalized voluntary euthanasia or its prohibition, in the context of a psychological understanding.

First do no harm: pressing concerns regarding euthanasia in Belgium

This article is concerned with the practice of euthanasia in Belgium. Background information is provided; then major developments that have taken place since the enactment of the Belgian Act on Euthanasia are analysed. Concerns are raised about (1) the changing role of physicians and imposition on nurses to perform euthanasia; (2) the physicians' confusion and lack of understanding of the Act on Euthanasia; (3) inadequate consultation with an independent expert; (4) lack of notification of euthanasia cases, and (5) organ transplantations of euthanized patients. Some suggestions designed to improve the situation and prevent abuse are offered.