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Velasco Sanz TR, Cabrejas Casero AM, Rodríguez González Y, Barbado Albaladejo JA, Mower Hanlon LF, Guerra Llamas MI. Opinions of nurses regarding Euthanasia and Medically Assisted Suicide. Nurs Ethics 2022; 29:1721-1738. [PMID: 35786045 DOI: 10.1177/09697330221109940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Safeguarding the right to die according to the principles of autonomy and freedom of each person has become more important in the last decade, therefore increasing regulation of Euthanasia and Medically Assisted Suicide (MAS). AIMS To learn the opinions that the nurses of the autonomous region of Madrid have regarding Euthanasia and Medically Assisted Suicide. RESEARCH DESIGN Cross-sectional descriptive study. PARTICIPANTS AND RESEARCH CONTEXT All registered nurses in Madrid. The study was done by means of a self-completed anonymous questionnaire. The variables studied were social-demographic, giving opinions about Euthanasia and MAS. ETHICAL CONSIDERATIONS Each participant was assured maximum confidentiality and anonymity, ensuring the ethical principles set out in the Declaration of Helsinki, as well as in the Organic Law 3/2018, on Personal Data Protection and guarantee of digital rights. FINDINGS A total of 489 nurses answered the questionnaire. In total, 75.7% of the nurses confirmed that Euthanasia should be regulated in Spain. 66.3% indicated that information on Euthanasia should be provided jointly by doctors and nurses, and 42.3% considered that it could be applied by both medical and nursing professionals. A total of 87.2% advocated the participation of nurses in health policy, influencing the drafting of the law. In the face of possible regulation, 35% would request Conscientious Objection, being closely related to their religious beliefs. DISCUSSION Different authors point out that nurses' perceptions and attitudes towards Euthanasia are conditioned by different factors, such as religion, gender, poor palliative care, legality and the patient's right to die. CONCLUSION Nurses are positioned in favour of the regulation and practice of Euthanasia and MAS, depending on their age, years of experience, training, model of care and especially religious beliefs.
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Affiliation(s)
- Tamara Raquel Velasco Sanz
- Department of Nursing, Faculty of Nursing, Physioterapy and Podology, University Complutense of Madrid, Spain; Critical Care Department, San Carlos University Hospital, Madrid, Spain; Ethics Commission College of Nursing of Madrid, Madrid, Spain
| | - Ana María Cabrejas Casero
- Ethics Commission College of Nursing of Madrid, Madrid, Spain; Oncology Department, Alcorcón University Hospital, Madrid, Spain
| | | | | | | | - María Isabel Guerra Llamas
- Department of Nursing, Faculty of Nursing, Physioterapy and Podology, 16734Univerity Complutense of Madrid, Spain; Ethics Commission College of Nursing of Madrid, Spain
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Bellon F, Mateos JT, Pastells-Peiró R, Espigares-Tribó G, Gea-Sánchez M, Rubinat-Arnaldo E. The Role of Nurses in Euthanasia: A Scoping Review. Int J Nurs Stud 2022; 134:104286. [DOI: 10.1016/j.ijnurstu.2022.104286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 05/13/2022] [Accepted: 05/20/2022] [Indexed: 10/18/2022]
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Nursing Students' Attitudes, Future Role, and Knowledge Regarding Euthanasia Due to Unbearable Mental Suffering: A Single-Site Pilot Study. Creat Nurs 2022; 28:61-68. [PMID: 35173064 DOI: 10.1891/cn-2021-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND This study examines the attitudes, view of their future role, and knowledge of nursing students regarding euthanasia due to unbearable mental suffering (UMS euthanasia) in Belgium. Nurses have a key role in this situation at many levels. The practice of euthanasia is expanding globally and laws are changing, making more research essential. METHOD A cross-sectional design and online survey were used. All nursing students at a Belgian university college participated. RESULTS The majority of nursing students had a high degree of acceptance towards UMS euthanasia and highlighted their important role in the euthanasia decision-making process, but also reported a lack of knowledge and skills. CONCLUSION Nursing education at all levels needs to recognize this knowledge gap, taking into account the complexity and broader context of end-of-life care.
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Van Humbeeck L, Piers R, De Bock R, Van Den Noortgate N. Flemish healthcare providers' attitude towards tiredness of life and euthanasia: a survey study. Aging Ment Health 2022; 26:205-211. [PMID: 33432838 DOI: 10.1080/13607863.2020.1870205] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To explore the legal understanding and attitudes of nurses and physicians in both acute and chronic geriatric care (Flanders, Belgium) regarding euthanasia in the context of tiredness of life in older people. METHOD Healthcare providers employed in acute care (59 geriatricians and 75 nurses of acute geriatric wards), as well as chronic care (135 general practitioners (GPs) and 76 nurses employed in nursing homes and home care services) were sent a survey with four case vignettes. For each case vignette, respondents were asked the following questions: (1) 'Does this case fit the due-care criteria of the euthanasia law?', (2) 'Do you consider this person to be tired of life?', (3) 'Can you comprehend this person's euthanasia request?'. RESULTS In cases of severe and life-limiting physical suffering, where the patient meets the legal criteria for euthanasia in Belgium, only 50% of physicians and nurses are aware of this legal basis. In case of tiredness of life without underlying pathology, nurses showed more comprehension for the euthanasia request compared to physicians (43.0% vs. 10.8%, p < 0.001). Physicians tend to assess the legal base of an euthanasia-request depending on the severity of physical morbidity, whereas nurses show a greater comprehension towards euthanasia-requests even in absence of severe illness. Geriatricians are more reserved regarding performing euthanasia themselves as compared to GPs, regardless of underlying pathology or reason for the euthanasia-request (p < 0.001). CONCLUSION The legal understanding and attitude of Flemish physicians and nurses towards tiredness of life and euthanasia in older patients differed to a great extent. This study showed (1) a lack of awareness of the legal basis for euthanasia in the context of ToL among all HCPs, (2) differences in the extent of comprehension between nurses and physicians and (3) differences in willingness to actually perform euthanasia between geriatricians and GPs. So even with the formulation of strict due-care criteria there is still room for interpretation. This creates a gray area and a discussion point between healthcare providers.
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Affiliation(s)
| | - Ruth Piers
- Department of Geriatric Medicine, Ghent University Hospital, Ghent, Belgium
| | - Reine De Bock
- Department of Geriatric Medicine, Ghent University Hospital, Ghent, Belgium
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Green G. Examining the religiosity of nursing caregivers and their attitudes toward voluntary and involuntary euthanasia. Int J Palliat Nurs 2021; 27:317-325. [PMID: 34459245 DOI: 10.12968/ijpn.2021.27.6.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Nurses play an important role in taking care of people who have a terminal illness. AIMS To examine nursing caregivers' religiosity as the mediator between voluntary and involuntary euthanasia, and to compare nursing caregiver religiosity groups and the voluntary and involuntary euthanasia attitudes of nurses and nursing students. METHODS A cross sectional design was applied and 298 nursing caregivers voluntarily participated and completed the questionnaire. FINDINGS Religiosity partially contributes as mediator between voluntary and involuntary euthanasia. All nursing caregiver religiosity groups show more support for voluntary euthanasia. Moreover, nursing students and nurses differ with respect to support for euthanasia in extreme situations, such as patients that are clinically brain-dead. CONCLUSION Findings may be attributed to the clash of religious values, due to the common injunction against taking a life especially as regards involuntary euthanasia.
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Affiliation(s)
- Gizell Green
- Lecturer, Nursing department, Ariel University, Ariel city, Israel
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Velasco Sanz TR, Pinto Pastor P, Moreno-Milán B, Mower Hanlon LF, Herreros B. Spanish regulation of euthanasia and physician-assisted suicide. JOURNAL OF MEDICAL ETHICS 2021; 49:medethics-2021-107523. [PMID: 34330794 DOI: 10.1136/medethics-2021-107523] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Abstract
In March 2021, the Spanish Congress approved the law regulating euthanasia, that regulates both euthanasia and physician-assisted suicide (PAS). In this article, we analyse the Spanish law regulating euthanasia and PAS, comparing it with the rest of the European laws on euthanasia and PAS (Netherlands, Belgium and Luxembourg). Identified strengths of the Spanish law, with respect to other norms, are that it is a law with many safeguards, which broadly recognises professionals' right to conscientious objection and the specification that it makes on the prior comprehensive care of the patient, including the approach to care dependency. Regarding its shortcomings, the law does not differentiate well between euthanasia and PAS; it barely assigns a role to the healthcare team as a whole (similar to other regulations); it does not clarify the functions of the different professionals involved; it does not detail the specific composition and duration of theevaluation commission; it has not been accompanied by a prior or simultaneous regulation of palliative care; and, lastly, the period of time to implement the law is too short.
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Affiliation(s)
- Tamara Raquel Velasco Sanz
- Departamento Enfermería, Complutense University of Madrid, Madrid, Spain
- Instituto de Ética Clínica Francisco Vallés, Universidad Europea, Madrid, Spain
| | - Pilar Pinto Pastor
- Medicina Legal, psiquiatría y patología, Complutense University of Madrid, Madrid, Spain
| | - Beatriz Moreno-Milán
- Instituto de Ética Clínica Francisco Vallés, Universidad Europea, Madrid, Spain
- Departamento de Psicología Clínica. Facultad de Psicología, Complutense University of Madrid, Madrid, Spain
| | - Lydia Frances Mower Hanlon
- Departamento Enfermería, Complutense University of Madrid, Madrid, Spain
- Instituto de Ética Clínica Francisco Vallés, Universidad Europea, Madrid, Spain
| | - Benjamin Herreros
- Instituto de Ética Clínica Francisco Vallés, Universidad Europea, Madrid, Spain
- Unidad de Medicina Interna, Hospital Universitario Fundacion Alcorcon, Alcorcón, Madrid, Spain
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Variath C, Peter E, Cranley L, Godkin D, Just D. Relational influences on experiences with assisted dying: A scoping review. Nurs Ethics 2020; 27:1501-1516. [PMID: 32436431 DOI: 10.1177/0969733020921493] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Family members and healthcare providers play an integral role in a person's assisted dying journey. Their own needs during the assisted dying journey are often, however, unrecognized and underrepresented in policies and guidelines. Circumstances under which people choose assisted dying, and relational contexts such as the sociopolitical environment, may influence the experiences of family members and healthcare providers. ETHICAL CONSIDERATIONS Ethics approval was not required to conduct this review. AIM This scoping review aims to identify the relational influences on the experiences of family members and healthcare providers of adults who underwent assisted dying and of those unable to access assisted dying due to the loss of capacity to consent. METHODS A literature search was conducted in four databases, including MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO. The search retrieved 12,074 articles, a number narrowed down to 172 articles for full-text screening. Thirty-six articles met the established inclusion criteria. A feminist relational framework guided the data analysis. RESULTS Five key themes on the influences of family members' and healthcare providers' experiences throughout the assisted dying process were synthesized from the data. They include (1) relationships as central to beginning the process, (2) social and political influences on decision making, (3) complex roles and responsibilities of family members and healthcare providers, (4) a unique experience of death, and (5) varying experiences following death. CONCLUSION The feminist relational lens, used to guide analysis, shed light on the effect of the sociopolitical influences and the relationships among patients, families, and healthcare providers on each other's experiences. Addressing the needs of the family members and healthcare providers is vital to improving the assisted dying process. Including families' and healthcare providers' needs within institutional policies and enhancing collaboration and communication among those involved could improve the overall experience.
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Bellens M, Debien E, Claessens F, Gastmans C, Dierckx de Casterlé B. “It is still intense and not unambiguous.” Nurses' experiences in the euthanasia care process 15 years after legalisation. J Clin Nurs 2019; 29:492-502. [DOI: 10.1111/jocn.15110] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 09/22/2019] [Accepted: 11/10/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Marthe Bellens
- Department of Public Health and Primary Care Academic Centre for Nursing and Midwifery KU Leuven Leuven Belgium
| | - Elisa Debien
- Department of Public Health and Primary Care Academic Centre for Nursing and Midwifery KU Leuven Leuven Belgium
| | - Fien Claessens
- Leuven Institute for Healthcare Policy KU Leuven Leuven Belgium
| | - Chris Gastmans
- Centre for Biomedical Ethics and Law KU Leuven Leuven Belgium
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Denier Y, de Casterlé BD, De Bal N, Gastmans C. Involvement of Nurses in the Euthanasia Care Process in Flanders (Belgium): An exploration of Two Perspectives. J Palliat Care 2018. [DOI: 10.1177/082585970902500404] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study explored nurses’ involvement in the care process for mentally competent, terminally ill patients requesting euthanasia in general hospitals in Flanders, Belgium. In-depth interviews with 18 nurses who had experience in caring for patients requesting euthanasia since May 2002 were analyzed using grounded theory qualitative methods. We found that the involvement of nurses in the care process is influenced by their predominant perspective on it: the procedural, action-focused perspective, from which good practical organization of the care process is essential; or the existential-interpretative perspective, from which it is important to understand the patient's request within a dialogue-focused and communicational atmosphere. Findings show that the two perspectives are not mutually exclusive, but rather complementary dimensions of the euthanasia care process. Hence, sufficient support for nurses to reach a well-balanced integration of both perspectives is essential.
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Affiliation(s)
- Yvonne Denier
- Y Denier (corresponding author): Centre for Biomedical Ethics and Law, Faculty of Medicine, Catholic University of Leuven, Kapucijnenvoer 35 blok d – bus 7001, 3000 Leuven, Belgium
| | | | - Nele De Bal
- N De Bal, C Gastmans: Centre for Biomedical Ethics and Law, Faculty of Medicine, Catholic University of Leuven
| | - Chris Gastmans
- N De Bal, C Gastmans: Centre for Biomedical Ethics and Law, Faculty of Medicine, Catholic University of Leuven
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Fujioka JK, Mirza RM, McDonald PL, Klinger CA. Implementation of Medical Assistance in Dying: A Scoping Review of Health Care Providers' Perspectives. J Pain Symptom Manage 2018; 55:1564-1576.e9. [PMID: 29477968 DOI: 10.1016/j.jpainsymman.2018.02.011] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 02/12/2018] [Accepted: 02/13/2018] [Indexed: 11/16/2022]
Abstract
RESEARCH AIMS With the growing interest in Medical Assistance in Dying (MAiD), understanding health care professionals' roles and experiences in handling requests is necessary to evaluate the quality, consistency, and efficacy of current practices. This scoping review sought to map the existing literature on health care providers' perspectives of their involvement in MAiD. METHODS A scoping review was conducted to address the following: 1) What are the roles of diverse health care professionals in the provision of MAiD? and 2) What professional challenges arise when confronted with MAiD requests? A literature search in electronic databases and gray literature sources was performed. Articles were screened, and a thematic content analysis synthesized key findings. RESULTS After evaluating 1715 citations and 148 full-text papers, 33 articles were included. Perspectives of nurses (n = 10), physicians (n = 7), mental health providers (n = 7), pharmacists (n = 4), social workers (n = 3), and medical examiners (n = 1) were explored. Professional roles included consulting/supporting patients and/or other staff members with requests, assessing eligibility, administering/dispensing the lethal drugs, providing aftercare to bereaved relatives, and regulatory oversight. Challenges included lack of clear guidelines/protocols, role ambiguity, evaluating capacity/consent, conscientious objection, and lack of interprofessional collaboration. CONCLUSION Evidence from various jurisdictions highlighted a need for clear guidelines and protocols that define each profession's role, scope of practice, and legal boundaries for MAiD. Comprehensive models of care that incorporate multidisciplinary teams alongside improved clinician education may be effective to support MAiD implementation. Little is known about health care providers' perspectives in handling requests, especially outside physician practice and nursing.
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Affiliation(s)
- Jamie K Fujioka
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Life Course and Aging, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada; National Initiative for the Care of the Elderly, Toronto, Ontario, Canada.
| | - Raza M Mirza
- Institute for Life Course and Aging, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada; National Initiative for the Care of the Elderly, Toronto, Ontario, Canada
| | - P Lynn McDonald
- Institute for Life Course and Aging, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada; National Initiative for the Care of the Elderly, Toronto, Ontario, Canada
| | - Christopher A Klinger
- Institute for Life Course and Aging, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada; National Initiative for the Care of the Elderly, Toronto, Ontario, Canada
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Bravo G, Rodrigue C, Arcand M, Downie J, Dubois MF, Kaasalaine S, Hertogh CM, Pautex S, Van den Block L. Nurses' perspectives on whether medical aid in dying should be accessible to incompetent patients with dementia: findings from a survey conducted in Quebec, Canada. Geriatr Nurs 2018; 39:393-399. [PMID: 29306500 DOI: 10.1016/j.gerinurse.2017.12.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 11/26/2017] [Accepted: 12/04/2017] [Indexed: 10/18/2022]
Abstract
We conducted a survey in a random sample of 514 Quebec nurses caring for the elderly to assess their attitudes towards extending medical aid in dying to incompetent patients and to explore associated factors. Attitudes were measured using clinical vignettes featuring a hypothetical patient with Alzheimer disease. Vignettes varied according to the stage of the disease (advanced or terminal) and the presence or absence of a written request. Of the 291 respondents, 83.5% agreed with the current legislation that allows physicians to administer aid in dying to competent patients who are at the end of life and suffer unbearably. A similar proportion (83%, p = 0.871) were in favor of extending medical aid in dying to incompetent patients who are at the terminal stage of Alzheimer disease, show signs of distress, and have made a written request before losing capacity.
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Affiliation(s)
- G Bravo
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada; Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Sherbrooke, QC, Canada.
| | - C Rodrigue
- Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Sherbrooke, QC, Canada
| | - M Arcand
- Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Sherbrooke, QC, Canada; Department of Family Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - J Downie
- Schulich School of Law and Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - M-F Dubois
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada; Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Sherbrooke, QC, Canada
| | - S Kaasalaine
- Department of Family Medicine, School of Nursing, McMaster University, Hamilton, ON, Canada
| | - C M Hertogh
- Department of General Practice & Elderly Care Medicine, EMGO+ Institute for Health and Care Research, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
| | - S Pautex
- Department of Community Medicine and Primary Care, Geneva University Hospital, Geneva, Switzerland
| | - L Van den Block
- VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Abstract
Background: Nurses’ voices remain unheard in most debates about euthanasia, although their crucial role in the euthanasia process is widely acknowledged. Moreover, in Canadian euthanasia law, nurses have a more active role, which further highlights the need for knowledge about nurses’ attitudes towards their role in the euthanasia process. Research questions: What are Finnish nurses’ attitudes towards their potential role in the euthanasia process? Which characteristics are associated with those attitudes? Research design: Cross-sectional web-based survey. Participants and research context: 1003 nurses, recruited via social media and the members’ bulletin of the Finnish Nurses Association. Ethical considerations: Ethical approval was obtained from the Committee on Research Ethics of the university to which the first author was affiliated. Findings: The great majority (85.2%) of nurses felt that their perspective should be considered in decision-making related to euthanasia. Furthermore, most of the participants (74.7%) reported willingness to participate in the euthanasia process if it were legal, and 88.6% agreed that a nurse should be present when euthanasia is performed if the patient wishes so. Furthermore, over half agreed that some of the preparatory tasks were part of their job description. However, a minority (32.9%) agreed with a possible obligation to participate based on their profession. Nurses’ age, religiosity and educational level influenced their attitudes in the current results. Discussion: Despite the strong agreement on decision-making concerning euthanasia and participation in the euthanasia process, obligation to participate based on the profession was rejected by most participants. Nurses regarded themselves as consultants in the decision-making process, which may indicate their unwillingness to share the responsibility for the decision itself. Conclusion: Specific safety mechanisms should be considered to protect nurses who refuse to be involved in the euthanasia process due to harm that involuntary participation might cause.
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Francke AL, Albers G, Bilsen J, de Veer AJE, Onwuteaka-Philipsen BD. Nursing staff and euthanasia in the Netherlands. A nation-wide survey on attitudes and involvement in decision making and the performance of euthanasia. PATIENT EDUCATION AND COUNSELING 2016; 99:783-789. [PMID: 26613667 DOI: 10.1016/j.pec.2015.11.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 10/30/2015] [Accepted: 11/07/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To give insight into Dutch nursing staff's attitudes and involvement regarding euthanasia. METHODS The sample was recruited from a nation-wide existent research panel of registered nurses and certified nursing assistants. Descriptive analyses and multivariate logistic regression analyses were performed. RESULTS 587 respondents (response of 65%) completed the questionnaire. The majority (83%) state that physicians have to discuss the decision about euthanasia with the nurses involved. Besides, 69% state that a physician should discuss a euthanasia request with nurses who have regular contact with a patient. Nursing staff who have religious or other beliefs that they consider important for their attitude towards end-of-life decisions, and staff working in a hospital or home care, are most likely to have this opinion. Being present during the euthanasia is quite unusual: only a small group (7%) report that this has ever been the case in their entire working life. Seven% (incorrectly) think they are allowed to administer the lethal drugs. CONCLUSION The majority want to be involved in decision-making processes about euthanasia. Not all are aware that they are not legally allowed to administer the lethal drugs. PRACTICE IMPLICATIONS Nursing staff should be informed of relevant existing legislation and professional guidelines.
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Affiliation(s)
- Anneke L Francke
- NIVEL-Netherlands Institute of Health Services Research, Utrecht, The Netherlands; Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU Medical Center, Amsterdam, The Netherlands; Expertise Center for Palliative Care Amsterdam, VU Medical Center, Amsterdam, The Netherlands.
| | - Gwenda Albers
- Federation Palliative Care Flanders, Vilvoorde, Belgium
| | - Johan Bilsen
- Mental Health and Wellbeing Research Group, Department of Public Health, Vrije Universiteit Brussel, Belgium
| | - Anke J E de Veer
- NIVEL-Netherlands Institute of Health Services Research, Utrecht, The Netherlands.
| | - Bregje D Onwuteaka-Philipsen
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU Medical Center, Amsterdam, The Netherlands; Expertise Center for Palliative Care Amsterdam, VU Medical Center, Amsterdam, The Netherlands
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15
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Abstract
Recent laws in Europe now allow for pediatric euthanasia. The author reviews some rationale for caution, and addresses why ensuring the availability of pediatric palliative care is an important step before allowing pediatric euthanasia.
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Affiliation(s)
- Brian S. Carter
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
- Bioethics Center, Children’s Mercy Hospital, Kansas City, MO, USA
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Tamayo-Velázquez MI, Simón-Lorda P, Cruz-Piqueras M. Euthanasia and physician-assisted suicide. Nurs Ethics 2012; 19:677-91. [DOI: 10.1177/0969733011436203] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study is to assess the knowledge, attitudes and experiences of Spanish nurses in relation to euthanasia and physician-assisted suicide. In an online questionnaire completed by 390 nurses from Andalusia, 59.1% adequately identified a euthanasia situation and 64.1% a situation involving physician-assisted suicide. Around 69% were aware that both practices were illegal in Spain, while 21.4% had received requests for euthanasia and a further 7.8% for assisted suicide. A total of 22.6% believed that cases of euthanasia had occurred in Spain and 11.4% believed the same for assisted suicide. There was greater support (70%) for legalisation of euthanasia than for assisted suicide (65%), combined with a greater predisposition towards carrying out euthanasia (54%), if it were to be legalised, than participating in assisted suicide (47.3%). Nurses in Andalusia should be offered more education about issues pertaining to the end of life, and extensive research into this area should be undertaken.
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Denier Y, Gastmans C, De Bal N, Dierckx de Casterlé B. Communication in nursing care for patients requesting euthanasia: a qualitative study. J Clin Nurs 2010; 19:3372-80. [DOI: 10.1111/j.1365-2702.2010.03367.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dierckx de Casterlé B, Denier Y, De Bal N, Gastmans C. Nursing care for patients requesting euthanasia in general hospitals in Flanders, Belgium. J Adv Nurs 2010; 66:2410-20. [DOI: 10.1111/j.1365-2648.2010.05401.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Benedict S, Shields L, O'Donnell AJ. Children's "euthanasia" in Nazi Germany. J Pediatr Nurs 2009; 24:506-16. [PMID: 19931148 DOI: 10.1016/j.pedn.2008.07.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2008] [Revised: 07/31/2008] [Accepted: 07/31/2008] [Indexed: 11/26/2022]
Abstract
Children with disabilities were killed during the Nazi era, often by nurses. Some nurses killed children, saying that they were under orders. Propaganda about the need for "racial purity" was all pervasive and influenced much of the population, including nurses. The German people accepted the "mercy" killing of children with disabilities. We describe the children's "euthanasia" program, explore the influence of propaganda, ask why it was acceptable to kill children, and provide historical context demonstrating "slippery slopes" which can lead to abrogation of ethical principles. Discussion of such history is essential as the ethical principles which were breached are still the cornerstone of nursing practice today. Only by openly discussing past wrongs can we attempt to ensure that they do not happen again. Archival documents from Germany and Israel, including trial depositions and transcripts, provided material, supplemented by secondary classic sources.
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Haigh C, Neville L. Editorial: A time to live, a time to die? An exploration of the arguments surrounding the legalisation of assisted suicide. J Clin Nurs 2009; 18:3213-5. [PMID: 19930082 DOI: 10.1111/j.1365-2702.2009.02978.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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