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Parra Jounou I, Triviño-Caballero R, Cruz-Piqueras M. For, against, and beyond: healthcare professionals' positions on Medical Assistance in Dying in Spain. BMC Med Ethics 2024; 25:69. [PMID: 38877494 PMCID: PMC11177400 DOI: 10.1186/s12910-024-01069-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 05/31/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND In 2021, Spain became the first Southern European country to grant and provide the right to euthanasia and medically assisted suicide. According to the law, the State has the obligation to ensure its access through the health services, which means that healthcare professionals' participation is crucial. Nevertheless, its implementation has been uneven. Our research focuses on understanding possible ethical conflicts that shape different positions towards the practice of Medical Assistance in Dying, on identifying which core ideas may be underlying them, and on suggesting possible reasons for this disparity. The knowledge acquired contributes to understanding its complexity, shedding light into ambivalent profiles and creating strategies to increase their participation. METHODS We conducted an exploratory qualitative research study by means of semi-structured interviews (1 h) with 25 physicians and nurses from primary care (12), hospital care (7), and palliative care (6), 17 women and 8 men, recruited from Madrid, Catalonia, and Andalusia between March and May 2023. Interviews were recorded, transcribed, and coded in Atlas.ti software by means of thematic and interpretative methods to develop a conceptual model. RESULTS We identified four approaches to MAiD: Full Support (FS), Conditioned Support (CS), Conditioned Rejection (CR), and Full Rejection (FR). Full Support and Full Rejection fitted the traditional for and against positions on MAiD. Nevertheless, there was a gray area in between represented by conditioned profiles, whose participation cannot be predicted beforehand. The profiles were differentiated considering their different interpretations of four core ideas: end-of-life care, religion, professional duty/deontology, and patient autonomy. These ideas can intersect, which means that participants' positions are multicausal and complex. Divergences between profiles can be explained by different sources of moral authority used in their moral reasoning and their individualistic or relational approach to autonomy. CONCLUSIONS There is ultimately no agreement but rather a coexistence of plural moral perspectives regarding MAiD among healthcare professionals. Comprehending which cases are especially difficult to evaluate or which aspects of the law are not easy to interpret will help in developing new strategies, clarifying the legal framework, or guiding moral reasoning and education with the aim of reducing unpredictable non-participations in MAID.
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Affiliation(s)
- Iris Parra Jounou
- Department of Philosophy, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Rosana Triviño-Caballero
- Department of Public Health and Maternal-Child Health-Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
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Arreciado Marañón A, García-Sierra R, Busquet-Duran X, Tort-Nasarre G, Feijoo-Cid M. Nursing students' attitude toward euthanasia following its legalization in Spain. Nurs Ethics 2024:9697330241238342. [PMID: 38491560 DOI: 10.1177/09697330241238342] [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: 03/18/2024]
Abstract
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.
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Affiliation(s)
| | - Rosa García-Sierra
- Primary Care Research Institut Jordi Gol (IDIAPJGol)
- Universitat Autònoma de Barcelona
- Grup de Recerca Multidisciplinar en Salut i Societat (GREMSAS)
| | - Xavier Busquet-Duran
- Catalan Institute of Health
- Grup de Recerca Multidisciplinar en Salut i Societat (GREMSAS)
- University Foundation of Bages (FUB), University of Vic. Central University of Catalunya
| | - Gloria Tort-Nasarre
- University of Lleida
- Autonomous University of Barcelona
- Institut Català de la Salut (ICS)
| | - Maria Feijoo-Cid
- Universitat Autònoma de Barcelona
- Grup de Recerca Multidisciplinar en Salut i Societat (GREMSAS)
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Tsemach R, Aharon AA. Decision-making process regarding passive euthanasia: Theory of planned behavior framework. Nurs Ethics 2024:9697330241238346. [PMID: 38449448 DOI: 10.1177/09697330241238346] [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: 03/08/2024]
Abstract
BACKGROUND Nurses have an essential role in caring for end-of-life patients. Nevertheless, the nurse's involvement in the passive euthanasia decision-making process is insufficient and lower than expected. OBJECTIVES To explore factors associated with nurses' intention to be involved in non-treatment decisions (NTD) regarding passive euthanasia decision-making versus their involvement in the palliative care of patients requesting euthanasia, using the Theory of Planned Behavior (TPB) framework. DESIGN A cross-sectional study utilizing a random sample. PARTICIPANTS AND RESEARCH CONTEXT The study was conducted in one of the largest hospitals in Israel among 125 nurses employed in internal and surgical care wards. Data was collected through face-to-face interviews between March and April 2019. METHOD A closed structured questionnaire was developed according to TPB instructions. A paired sample t test and two multiple hierarchical regressions were conducted. Variance explained (R2) and the significance of F change were calculated for each regression. The study used the STROBE statement guideline. ETHICAL CONSIDERATIONS The study was approved by the hospital's Helsinki Committee (#20.11.2017). FINDINGS A paired sample t test revealed that nurses' involvement in the palliative care of patients requesting passive euthanasia was significantly higher than in NTD regarding euthanasia. Regression analyses revealed that nurses' position and attitudes explain their intention to be involved in decision-making; attitudes and perceived behavioral control explain nurses' intention to be involved in the care of patients requesting euthanasia. CONCLUSIONS According to the TPB, nurses' attitudes explained their intention to participate in decision-making regarding passive euthanasia. It is recommended to enhance open discussion of this complex issue to encourage nurses' willingness to participate in NTD decision-making regarding euthanasia.
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Ortega-Galán ÁM, Ibáñez-Masero O, Fernández-Martínez E, Ortiz-Amo R, Fernández-Santos L, Ruiz-Fernández MD. The paradoxical position of nurses regarding euthanasia and its legalisation: A descriptive quantitative study. J Clin Nurs 2023; 32:8007-8016. [PMID: 37715363 DOI: 10.1111/jocn.16869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 07/04/2023] [Accepted: 08/21/2023] [Indexed: 09/17/2023]
Abstract
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.
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Affiliation(s)
| | | | | | - Rocío Ortiz-Amo
- Department of Psychology, Area of Social Work and Social Services, University of Almería, Almería, Spain
| | | | - María Dolores Ruiz-Fernández
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almería, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Temuco, Chile
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van den Bosch G, van Schaik M, Pasman HR, Janssens R, Widdershoven G, Metselaar S. Moral Challenges of Nurses and Volunteers in Dutch Palliative Care. A Qualitative Study. J Palliat Care 2023; 38:364-371. [PMID: 35612868 PMCID: PMC10350729 DOI: 10.1177/08258597221098129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: To identify moral challenges experienced by nurses and volunteers in palliative care. Methods: A qualitative hermeneutic research design was used. Interviews with nurses (N = 10) and volunteers (N = 4) working in palliative care, in-home care, and hospice setting. Participants were recruited through maximum variation, a purposive sampling technique. Transcriptions were analyzed using qualitative thematic content analysis and open coding. Results: Two themes were identified, each with three subthemes: theme (A) Moral challenges regarding organizational and professional aspects contained the subthemes (1) dealing with protocols and regulations, (2) different professional perspectives on good care, and (3) limits of professionalism. Theme (B) Moral challenges regarding the patient and their family members contained the subthemes (1) dealing with the patient's wishes, (2) the patient's wish to die, and (3) dealing with family members. Conclusion: Nurses and volunteers working in palliative care are confronted with a wide range of moral challenges. Insight into 'real-world ethical challenges' of healthcare providers is important to provide adequate support to nurses and volunteers working in palliative care.
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Affiliation(s)
| | | | | | - Rien Janssens
- Ethics, Law and Humanities, Amsterdam, the Netherlands
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Ziwei K, Mengjiao C, Yongjie Z, Mengqi Z, Yeqin Y. Optimizing palliative care education through undergraduate nursing students' perceptions: Application of importance-performance analysis and Borich needs assessment model. NURSE EDUCATION TODAY 2023; 122:105719. [PMID: 36738533 DOI: 10.1016/j.nedt.2023.105719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND With the aging of the population and the increasing trend of chronic illnesses, the demand for palliative care is growing. Undergraduate nursing students will be the main providers of palliative care in the future. Therefore, it's important to enhance their capability for palliative care. OBJECTIVES The purpose of this study was to optimize palliative care education, based on undergraduate nursing students' perceptions and educational needs through the application of the importance-performance analysis and Borich needs assessment model. DESIGN A cross-sectional descriptive study. SETTING Nursing department in Wenzhou, China. PARTICIPANTS A total of 448 full-time undergraduate nursing students were recruited for the study. METHODS Importance-performance analysis was used to identify items that obtain high priority for improvement, and the Borich needs assessment model and the Locus for focus model were used to prioritize educational needs. The three methods were integrated to determine the top-priority content to meet undergraduate nursing students' educational needs in palliative care. RESULTS The items located in Quadrant II of Importance-performance analysis, ranked in the first 10 in Borich needs assessment, and located in Quadrant I of the Locus for focus model were defined as top-priority content. These included: "respiratory symptoms: pleural effusion, superior vena cava syndrome, respiratory difficulty," "Care of terminal symptoms," "Awareness of dying," "Care of remains," "Cooperation between interdisciplinary teams," and "Rights and interests of dying patients." CONCLUSION Several years of development of palliative care education have made nursing students aware of its importance. However, they have reported that education remains insufficient. A greater focus on palliative care education is needed to ensure they are better prepared. Specific attention should be given to cooperation between interdisciplinary teams, dealing with death and dying, rights and interests of people who were dying.
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Affiliation(s)
- Ke Ziwei
- Department of Nursing, Taizhou Hospital Affiliated to Wenzhou Medical University, Tazihou 317000, Zhejiang, China
| | - Chen Mengjiao
- Faculty of Nursing, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Zhang Yongjie
- Faculty of Nursing, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Zhang Mengqi
- Faculty of Nursing, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Yang Yeqin
- Faculty of Nursing, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China.
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Demedts D, Cools W, Fobelets M, Tricas-Sauras S, Bilsen J. Nursing students' attitudes regarding euthanasia due to unbearable mental suffering: Cross-sectional study using the adapted and validated Euthanasia Attitude Scale. J Adv Nurs 2023; 79:676-685. [PMID: 36534409 DOI: 10.1111/jan.15539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/30/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022]
Abstract
AIM To explore final year nursing students' attitudes towards euthanasia due to unbearable mental suffering by using the adapted and validated Euthanasia Attitude Scale. DESIGN Cross-sectional survey. METHODS Explorative, descriptive cross-sectional study conducted using an e-mail survey between October 2020 and March 2021 by a sample of final-year baccalaureate nursing students (n = 273) from eight of the eleven Flemish university colleges. The actual questionnaire contains 21 questions and was developed based on a consensus reached following independent translations. The psychometric properties of the Euthanasia Attitude Scale were assessed, including reliability and validity. Independent-sample Mann-Whitney U-test was used to investigate relation between demographic and education-related data, and domain and total score of the UMS-EAS-NL. This study received ethical approval from the Ethical Committee of the University Hospital Brussels, Belgium. RESULTS McDonald's omega was 0.838 for the total Euthanasia Attitude Scale scores, supporting the validity of the questionnaire. A statistically significant difference in 'Naturalistic beliefs' score was found relating to the year of birth. There are clinically important results between those students who have been involved in euthanasia and those who have not. CONCLUSIONS Most of the final-year nursing students supported the probability of patients' access to euthanasia due to unbearable mental suffering. To monitor adequate care, it is necessary to prepare nursing students adequately for this complex matter. IMPACT To date, no large-scale study has examined nursing students' attitudes towards euthanasia because of unbearable mental suffering. It is expected that nursing students may be confronted with such a euthanasia request during an internship, or later in their professional career, in countries where euthanasia is legal. Students showed a high acceptability towards UMS-euthanasia. Clinically significant differences were found for students who had ever been involved in euthanasia.
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Affiliation(s)
- Dennis Demedts
- Research Group Mental Health and Wellbeing, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Expertise Center BruCHI, Department of Health, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
| | - Wilfried Cools
- Biostatistics and Medical Informatics Research group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Maaike Fobelets
- Expertise Center BruCHI, Department of Health, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium.,Biostatistics and Medical Informatics Research group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Teacher Education, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Sandra Tricas-Sauras
- Expertise Center BruCHI, Department of Health, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
| | - Johan Bilsen
- Research Group Mental Health and Wellbeing, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Hol H, Vatne S, Strømskag KE, Orøy A, Rokstad AMM. Norwegian nurses' perceptions of assisted dying requests from terminally ill patients-A qualitative interview study. Nurs Inq 2023; 30:e12517. [PMID: 35975335 PMCID: PMC10078436 DOI: 10.1111/nin.12517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/19/2022] [Accepted: 07/29/2022] [Indexed: 01/25/2023]
Abstract
This study explores the perceptions of Norwegian nurses who have received assisted dying requests from terminally ill patients. Assisted dying is illegal in Norway, while in some countries, it is an option. Nurses caring for terminally ill patients may experience ethical challenges by receiving requests for euthanasia and assisted suicide. We applied a qualitative research design with a phenomenological hermeneutic approach using open individual interviews. A total of 15 registered nurses employed in pulmonary and oncology wards of three university hospitals and home care in one municipality were recruited. Four themes emerged from the analysis: (1) unprepared for the request; (2) meeting direct, indirect, and nonverbal requests; (3) working in a gray zone, and (4) feeling alone and powerless. The study found that nurses were unsure how to handle such requests due to professional uncertainty about assisted dying. Working in an environment where the topic is taboo made nurses morally uncertain, and some perceived this as moral distress. The hospital chaplain played a significant role in providing support to these nurses.
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Affiliation(s)
- Hege Hol
- Faculty of Health Science and Social Care, Molde University College, Molde, Norway
| | - Solfrid Vatne
- Faculty of Health Science and Social Care, Molde University College, Molde, Norway
| | | | - Aud Orøy
- Faculty of Health Science and Social Care, Molde University College, Molde, Norway
| | - Anne Marie Mork Rokstad
- Faculty of Health Science and Social Care, Molde University College, Molde, Norway.,Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
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Ortega-Galán ÁM, Ruiz-Fernández MD, Alcaraz-Córdoba A, Gómez-Beltrán PA, Díaz-Morales D, Ortiz-Amo R. Nursing students' perceptions of euthanasia legislation: A qualitative study. NURSE EDUCATION TODAY 2022; 116:105466. [PMID: 35834867 DOI: 10.1016/j.nedt.2022.105466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 06/19/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Affiliation(s)
| | - María Dolores Ruiz-Fernández
- Department of Nursing, Physiotherapy, and Medicine, University of Almeria, Almería, Spain; Facultad Ciencias de la Salud, Universidad Autónoma de Chile, Providencia, Chile.
| | - Andrea Alcaraz-Córdoba
- Department of Nursing, Physiotherapy, and Medicine, University of Almeria, Almería, Spain
| | | | | | - Rocío Ortiz-Amo
- Department of Nursing, Physiotherapy, and Medicine, University of Almeria, Almería, Spain
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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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Snir JT, Ko DN, Pratt B, McDougall R. Anticipated impacts of voluntary assisted dying legislation on nursing practice. Nurs Ethics 2022; 29:1386-1400. [PMID: 35620841 PMCID: PMC9527354 DOI: 10.1177/09697330211022409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: The Voluntary Assisted Dying Act 2017 passed into law in Victoria, Australia,
on the 29 November 2017. Internationally, nurses have been shown to be
intimately involved in patient care throughout the voluntary assisted dying
process. However, there is a paucity of research exploring Australian
nurses’ perspectives on voluntary assisted dying and, in particular, how
Victorian nurses anticipate the implementation of this ethically
controversial legislation will impact their professional lives. Objectives: To explore Victorian nurses’ expectations of the ethical and practical
impacts the voluntary assisted dying legislation will have on their
professional lives. Research design: This qualitative study analysed nurses’ free text responses collected as part
of a larger mixed methods online survey investigating staff views on the
Voluntary Assisted Dying Act. Data were collected during the period between
the passing of the voluntary assisted dying legislation and the start date
and were analysed using inductive content analysis. Participants and research context: Free text survey responses were analysed from 1873 nurses employed across
seven Victorian health services located in both metropolitan and regional
areas of the state. Ethical considerations: The study obtained research ethics approval and all participants were
informed of the voluntary and anonymous nature of their participation. Findings: This study identified three broad areas of Victorian nurses’ professional
lives that they expected to be impacted by the implementation of voluntary
assisted dying: professional identity, career development and workplace
relationships. Conclusion: Participants anticipate diverse and nursing-specific impacts of the
implementation of voluntary assisted dying in Victoria. Their insights can
inform health services in jurisdictions considering or already implementing
voluntary assisted dying, to develop policies, procedures and staff training
programmes that safeguard the well-being and legal rights of their nursing
staff.
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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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Kalender Smajlović S. Odnos medicinskih sester do evtanazije. OBZORNIK ZDRAVSTVENE NEGE 2022. [DOI: 10.14528/snr.2022.56.1.3103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Uvod: Evtanazija je pojem, o katerem se mora razpravljati z vidika medicinskih, zdravstvenih in družboslovnih strok. Medicinske sestre so sestavni del zdravstvenih timov, zato je potrebno njihovo vključevanje v etične razprave o evtanaziji. Namen pregleda literature je predstaviti vidik evtanazije v povezavi z zdravstveno nego.Metode: Uporabljen je bil pregled literature, izveden v podatkovnih bazah COBIB.SI, CIHAHL in PubMed od 1. 11. 2020 do 1. 12. 2020. Iskanje je potekalo z uporabo ključnih besed: »evtanazija«, »zdravstvena nega«, v angleškem jeziku s kombinacijo ključnih besed: »attitudes«, »euthanasia« in »nursing«. Potek pregleda literature je prikazan z diagramom PRISMA. Kakovost virov, vključenih v končno analizo, je bila ocenjena s pomočjo hierarhije dokazov. Rezultati so bili sintetizirani z uporabo tematske analize.Rezultati: Izmed 138 virov je bilo v končno analizo vključenih enaindvajsetih člankov. Medicinske sestre so navajale naklonjen, kot tudi nenaklonjen odnos ter prisotnost etičnih dilem v povezavi z evtanazijo. Naklonjen odnos medicinskih sester do evtanazije se kaže v primerih neobvladljivih bolečin, neznosnega trpljenja in neozdravljivih bolezni, nenaklonjen pa v povezavi z nekaterimi demografskimi in kulturnimi značilnostmi medicinskih sester, upoštevanjem načel sočutne oskrbe in spoštovanjem vrednosti človekovega življenja.Diskusija in zaključek: Ugotovitve raziskave prispevajo prepoznati odnos medicinskih sester do evtanazije ter nekatere etične dileme v povezavi z evtanazijo. Potrebno bi bilo izvesti podrobne preglede etičnih dilem in moralnih stisk, ki se pojavljajo v povezavi z evtanazijo in zdravstveno nego.
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Krol P, Amiri M, Vonarx N. De l’aide médicale à mourir au Québec : une analyse du contexte et de la pratique infirmière en soins palliatifs. Rech Soins Infirm 2022; 147:67-81. [DOI: 10.3917/rsi.147.0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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De Hert M, Thys E, Catthoor K, Van den Broeck K, Matthys F, Vansteelandt K, Detraux J. Media coverage of Belgium's first criminal case concerning euthanasia for psychiatric patients: A content analysis of Flemish newspapers and magazines. Front Psychiatry 2022; 13:1050086. [PMID: 36684025 PMCID: PMC9845880 DOI: 10.3389/fpsyt.2022.1050086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/05/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Belgium is one of the few countries worldwide where euthanasia on the grounds of unbearable suffering caused by a psychiatric disorder is legally possible. In April 2010 euthanasia was carried out on a 38-year-old Belgian woman with borderline personality disorder and/or autism. After a complaint by the family, three physicians were referred to the Court of Assizes on the charge of "murder by poisoning". METHODS A content analysis of print and online news coverage of the euthanasia case in a selected sample of Flemish newspapers and magazines, published between December 1, 2019 and March 1, 2020, was conducted to analyze the prominence and framing of the euthanasia case, as well as the portrayal of key figures in this case. A quantitative analysis, as well as an in-depth qualitative analysis (with the aid of NVivo 1.0 software) was performed. RESULTS One thousand two hundred fifteen news articles were identified through database searching. Of these, 789 articles were included after screening for relevance and eligibility. Mean prominence scores were moderate and did not statistically significantly differ between newspapers with a different historical ideological background or form (elite versus popular). The most frequent headline topics featured legal aspects (relating to the Belgian Euthanasia Law or the course of the trial). Headlines and content of most articles (90 and 89%, respectively) did not contain an essential standpoint on the euthanasia case itself or, if they did, were neutral. Historical ideological background, nor form of newspaper (elite versus popular) significantly influenced headline tone or article direction toward the euthanasia case. Despite this, our qualitative analysis showed some subtle differences in selection, statement or tonality of reports between certain newspapers with a different historical ideological background. CONCLUSION Although major Flemish newspapers and magazines generally were neutral in their coverage of the judicial case, major points of contention discussed were: the need for an evaluation and possible amendments to the existing Euthanasia Law, including a revision of the Belgian Control Commission and the system of penalties for physicians, and the absence of any consensus or guidance on how to define psychological suffering.
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Affiliation(s)
- Marc De Hert
- University Psychiatric Center KU Leuven, Leuven, Belgium.,Department of Biomedical Sciences, Research Group Psychiatry, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium.,Antwerp Health Law and Ethics Chair - AHLEC University Antwerpen, Antwerp, Belgium
| | - Erik Thys
- Psycho-Sociaal Centrum, St.-Alexius-Elsene Vzw, Ixelles, Belgium
| | - Kirsten Catthoor
- Ziekenhuis Netwerk Antwerpen (ZNA), Antwerp, Belgium.,The Collaborative Antwerp Psychiatric Research Institute (CAPRI) and Family Medicine and Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium.,Flemish Psychiatric Association, Kortenberg, Belgium
| | - Kris Van den Broeck
- The Collaborative Antwerp Psychiatric Research Institute (CAPRI) and Family Medicine and Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium.,Flemish Psychiatric Association, Kortenberg, Belgium
| | - Frieda Matthys
- Flemish Psychiatric Association, Kortenberg, Belgium.,Department of Psychiatry, University Hospital Brussels, Brussels, Belgium
| | - Kristof Vansteelandt
- Department of Biomedical Sciences, Research Group Psychiatry, KU Leuven, Leuven, Belgium
| | - Johan Detraux
- Department of Biomedical Sciences, Research Group Psychiatry, Public Health Psychiatry, KU Leuven, Leuven, Belgium
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The Attitude of Iranian Critical Care Nurses Toward Euthanasia: A Multicenter Cross-sectional Study. Crit Care Nurs Q 2021; 45:62-73. [PMID: 34818299 DOI: 10.1097/cnq.0000000000000389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Today, one of the major ethical challenges facing the world's health care system, and in particular nurses in the intensive care unit, is euthanasia or death out of pity. The aim of this study was to investigate the attitude of Iranian nurses in the intensive care unit toward euthanasia. This was an analytical cross-sectional study using census sampling. The data collection tool was the Euthanasia Attitude Scale. A total of 206 nurses working in the intensive care unit in 4 hospitals in the Mazandaran province of Iran were included in this study. The mean of total Euthanasia Attitude Scale score in intensive care unit nurses was 2.96. The mean euthanasia dimensions were ethical consideration, practical considerations, treasuring life, and naturalistic beliefs, 3.03, 2.92, 2.98, and 2.99, respectively. There was significant but low negative correlation between age and total Euthanasia Attitude Scale score, ethical considerations, and practical considerations. Male nurses exhibited significantly higher Euthanasia Attitude Scale scores, specifically in regard to ethical and practical considerations compared with female nurses. The most Iranian nurses in the intensive care unit had a negative attitude toward euthanasia for patients in the later stages of the disease. However, this opposition was less than similar studies in Iran in the past.
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