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Demedts D, Fobelets M, Tricas-Sauras S, Bilsen J. Nursing students' view on their future role and skills regarding euthanasia due to unbearable mental suffering: A mixed-method Study. Nurse Educ Pract 2023; 71:103718. [PMID: 37451166 DOI: 10.1016/j.nepr.2023.103718] [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: 01/26/2023] [Revised: 06/03/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023]
Abstract
AIM To explore final-year bachelor nursing students' view on their future role and skills regarding euthanasia due to unbearable mental suffering (UMS-euthanasia) and to discover possible education needs. BACKGROUND Since UMS-euthanasia is legal in Belgium, nursing students will be confronted with this issue during their future internship, or professional career. Graduated nurses believe to have an important role in the process of euthanasia where good communication skills and sufficient legal knowledge are essential. DESIGN Mixed-methods sequential explanatory design. METHODS First, a questionnaire was administered to all final-year bachelor nursing students at eight university colleges in Flanders (October 2020 and March 2021). Second, qualitative information was collected by organising focus groups with these students to gain more insights into the quantitative results (October 2021). RESULTS The final-year nursing students from the survey (n = 249) and from the three focus groups (n = 21) see a clear future role for themselves in the decision-making process, as well as in supporting the patient and family before, during and after UMS-euthanasia, but not in assisting in administering UMS-euthanasia. However, they also indicate they lack knowledge and skills in dealing adequately with UMS-euthanasia. Psychiatric internship alumni perceive a diminished role for themselves in the preparatory acts (p < 0.05). Ever involved in euthanasia shows a statistically significant difference in the demand for simulation. CONCLUSIONS Nursing students see an important role for nurses in UMS-euthanasia but feel inadequately prepared to take on this role. A combination of theoretical knowledge, clinical experience, open discussions, reflection and simulation is an opportunity to prepare nurses for their future role.
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Affiliation(s)
- Dennis Demedts
- Research group Mental Health and Wellbeing, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium; Expertise Center BruCHI, Department of Health, Erasmus Brussels University of Applied Sciences and Arts, Laarbeeklaan 121, 1090 Brussels, Belgium.
| | - Maaike Fobelets
- Expertise Center BruCHI, Department of Health, Erasmus Brussels University of Applied Sciences and Arts, Laarbeeklaan 121, 1090 Brussels, Belgium; Department of teacher education, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Sandra Tricas-Sauras
- Expertise Center BruCHI, Department of Health, Erasmus Brussels University of Applied Sciences and Arts, Laarbeeklaan 121, 1090 Brussels, Belgium
| | - Johan Bilsen
- Research group Mental Health and Wellbeing, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium
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Richardson S. An international expansion in voluntary euthanasia/assisted dying: The implications for nursing. Int Nurs Rev 2023; 70:117-126. [PMID: 36271824 DOI: 10.1111/inr.12807] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 09/03/2022] [Indexed: 11/30/2022]
Abstract
AIM To provide an update on the international position of assisted dying legislation and its implications for nursing policy. BACKGROUND Assisted dying legislation has been introduced in health systems in Europe, North America and Australasia (Australia and New Zealand). Despite contributions in research literature, this remains focussed on medical practitioners, with limited acknowledgement of the need for policy development in nursing. DISCUSSION There is a need for critical evaluation of this contemporary issue and the significance for nursing practice of the lack of unified nursing perspective and robust policy guidance is identified. An overview of the existing role of voluntary euthanasia/assisted dying with recent developments is provided and the resulting concerns for nurses regarding the scope of practice, role confusion and conflicting professional values is considered. CONCLUSION Despite a long history of assisted dying and the continued expansion of these practices, limited and highly variable nursing policy highlights the lack of clear guidance available to nurses. The growing inclusion of nurse practitioners and recognition of registered nurse involvement in the care of individuals on an assisted dying pathway merits clearer support from regulatory authorities and professional organisations. IMPLICATIONS FOR NURSING PRACTICE Nurses are the most likely health professionals to be approached with questions regarding assisted dying; they are intimately involved in patient experiences and need to understand what is possible, expected and legal in terms of their scope of practice regarding assisted dying. IMPLICATIONS FOR NURSING POLICY Nursing regulators and professional representatives need to provide clear policy statements and guidance identifying the nursing role and recognising where protections and support are necessary.
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Affiliation(s)
- Sandra Richardson
- Faculty of Health, University of Canterbury, Christchurch, New Zealand
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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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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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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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Ethical, Policy, and Practice Implications of Nurses' Experiences With Assisted Death: A Synthesis. ANS Adv Nurs Sci 2020; 42:216-230. [PMID: 31335329 PMCID: PMC6686960 DOI: 10.1097/ans.0000000000000276] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The conceptualization of assisted death as an act performed by physicians has resulted in a lack of attention to nurses' roles and experiences with the processes that surround an assisted death. In this article, we synthesize evidence from 6 articles focusing on the experiences of 55 nurses from Canada, Belgium, and the Netherlands, with relevant ethical and policy implications derived from the literature. Nurses have a central role in negotiating inquiries about assisted death and in providing wraparound care for patients, families, and other health care providers. This role is impactful for nurses and requires significant personal and professional moral work.
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Demedts D, Roelands M, Libbrecht J, Bilsen J. The attitudes, role & knowledge of mental health nurses towards euthanasia because of unbearable mental suffering in Belgium: A pilot study. J Psychiatr Ment Health Nurs 2018; 25:400-410. [PMID: 29802774 DOI: 10.1111/jpm.12475] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 05/16/2018] [Accepted: 05/23/2018] [Indexed: 12/20/2022]
Abstract
UNLABELLED WHAT IS KNOWN ABOUT THE SUBJECT?: Euthanasia because of unbearable mental suffering (UMS euthanasia) has been legal in Belgium since 2002 under strict conditions of careful practice. UMS euthanasia occurs fairly rarely in Belgium, but the frequency has increased substantially over the past few years. Although most mental health nurses play an important role and are supportive of euthanasia in general, their role, attitude and knowledge when it comes to UMS euthanasia were unknown until now. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Most mental health nurses in Belgium appear to be supportive towards UMS euthanasia and where UMS euthanasia is carried out, mental health nurses are often involved in the preceding decision-making process. Mental health nurses critically reflect on the interpretation and application of the legal euthanasia criteria as experienced in their daily work with their patients, and identify several problems. After a rather quiet period in Belgium, the public ethical debate regarding UMS euthanasia has recently been reopened and intensified. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Sufficient attention must be paid to how mental health nurses can be involved in the process of UMS euthanasia. This applies at several levels: legal, healthcare policy, bedside care and education. Specific attention must be paid within the UMS euthanasia process to ensure adequate cooperation between physicians, nurses and patients. There is a need for proper training in: knowledge of psychiatric pathologies and remaining treatment options; communication skills; the legal framework and all its difficulties; transdisciplinary and multicultural approaches; ethical reflection and how nurses handle their own emotions. ABSTRACT Introduction Euthanasia because of unbearable mental suffering (UMS euthanasia) has been legal in Belgium since 2002, under certain circumstances that govern careful practice. Despite the legal framework, there are specific difficulties and concerns regarding UMS euthanasia. Mental health nurses are often involved in the process, but little is known about their attitudes towards UMS euthanasia, their role and their knowledge. Aim To determine the attitudes, role and knowledge of mental health nurses regarding UMS euthanasia. Methods A cross-sectional survey was performed at a convenience sample of four psychiatric hospitals in Belgium (n = 133) as a pilot study. Self-administered questionnaires were provided to mental health nurses. Results Half the nurses in our sample had been involved at least once in the process of UMS euthanasia. A large majority of mental health nurses were supportive of UMS euthanasia. Nurses show differences in attitudes related to the different psychiatric pathologies of the patients, and in whether or not minors are involved. In some cases, they believed that the mental suffering of psychiatric patients can be unbearable and irreversible and that psychiatric patients can be competent to voluntarily request UMS euthanasia. Nurses stated that they have an important role in the UMS euthanasia process, but also demanded more knowledge and clear guidelines to implement the procedure. Discussion Nurses have a key role regarding UMS euthanasia but face several challenges: the recent process, resistance to a multidisciplinary approach by psychiatrists and an unclear role defined by the legal framework. Nurses do not appear to have a common voice on the topic and the development of clear guidelines appears to be essential. Social recovery can offer a way out of an UMS euthanasia request, but it will not always offer a solution. Implications for Practice Sufficient attention must be paid to how mental health nurses can be involved in the process of UMS euthanasia at various levels: bedside practice, healthcare management, education and policy. A form of systematic cooperation between nurses, physicians and patients can contribute to the utmost careful decision-making process needed in these cases. There is a need for proper training in: knowledge of psychiatric pathologies and remaining treatment options; communication skills; the legal framework and all its difficulties; transdisciplinary and multicultural approaches; ethical reflection and how nurses handle their own emotions.
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Affiliation(s)
- Dennis Demedts
- Research group Mental Health and Wellbeing, Vrije Universiteit Brussels (VUB), Brussels, Belgium.,Department of Health and Landscape Architecture, Erasmus University College Brussels (EhB), Brussels, Belgium.,Knowledge Center Brussels Integrated Care, Erasmus University College Brussels, Brussels, Belgium
| | - Marc Roelands
- Research group Mental Health and Wellbeing, Vrije Universiteit Brussels (VUB), Brussels, Belgium
| | - Julien Libbrecht
- Department of Health and Landscape Architecture, Erasmus University College Brussels (EhB), Brussels, Belgium
| | - Johan Bilsen
- Research group Mental Health and Wellbeing, Vrije Universiteit Brussels (VUB), Brussels, Belgium
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Wilson M, Oliver P, Malpas P. Nurses' views on legalising assisted dying in New Zealand: A cross-sectional study. Int J Nurs Stud 2018; 89:116-124. [PMID: 29669685 DOI: 10.1016/j.ijnurstu.2018.03.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 03/13/2018] [Accepted: 03/16/2018] [Indexed: 10/17/2022]
Abstract
AIMS This study investigated New Zealand nurses' views on legalising assisted dying across a range of clinical conditions, nurses' willingness to engage in legal assisted dying, potential deterrents and enablers to such engagement, and nurses' perceptions of the proper role of their professional bodies in relation to legalising assisted dying. BACKGROUND A Bill for legalising assisted dying is currently before the New Zealand parliament. Of the 16 jurisdictions where assisted dying has been specifically legislated, only the Canadian federal statute provides nurses with explicit legal protection for their performance of assisted dying-related tasks. An absence of policy development and planning for safe nursing practice prior to legalisation of assisted dying results in a gap in professional support and guidance. DESIGN Exploratory cross-sectional survey. RESPONDENTS A self-selected sample of 475 New Zealand nurses responded to an anonymous online survey disseminated through the newsletters and websites of relevant medical and nursing professional bodies. A sub-sample of nurses who expressed support for or ambivalence about legalisation (n = 356): rated their level of support for legalising assisted dying in New Zealand across a range of medical conditions, and their willingness to participate in a range of assisted dying tasks; identified barriers and facilitators to potential participation; and assessed the responsibility of the professional bodies to provide practice supports. METHOD Mixed-method approach using descriptive analysis of quantitative data; qualitative data were analysed thematically. RESULTS Nurses supported legalisation at a rate (67%) significantly greater than that of doctors (37%) and for a diverse range of medical conditions. Most supporting nurses were willing to engage in the full range of relevant assisted dying roles. They identified several practical and ethical supports as essential to safe engagement, in particular practice guidelines, specific training, legal protections, clinical supervision and mentoring, and independent review of assisted dying service provision. They saw the facilitation of these supports as primarily the responsibility of their professional bodies. IMPLICATIONS FOR POLICY Nursing bodies should proactively facilitate workforce awareness and development of assisted dying policy and practice supports in anticipation of legalisation. This can be done through information campaigns and by adapting assisted dying policy, practice materials and systems already developed internationally. Nursing bodies need to engage in formulating legislation to ensure inclusion of explicit protections for participating nurses and to delegate relevant responsibilities to regulatory bodies.
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Affiliation(s)
- Michael Wilson
- Wilson Associates, 22 Pitt St, Marden, South Australia, Australia.
| | - Pam Oliver
- Pam Oliver Ltd., Research and Evaluation, 1 Newton Rd., Waiheke Island, New Zealand.
| | - Phillipa Malpas
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
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Ay MA, Öz F. Nurses attitudes towards death, dying patients and euthanasia: A descriptive study. Nurs Ethics 2018; 26:1442-1457. [DOI: 10.1177/0969733017748481] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background: Attitudes of nurses towards death and related concepts influence end-of-life care. Determining nurses’ views and attitudes towards these concepts and the factors that affect them are necessary to ensure quality end-of-life care. Objectives: The purpose of this study was to determine nurses’ views and attitudes about death, dying patient, euthanasia and the relationships between nurses’ characteristics. Methods: Participants consist of the nurses who volunteered to take part in this descriptive study from 25 hospitals (n = 340) which has a paediatric or adult intensive care unit and located within the boundaries of Ankara, Turkey. ‘Nurse Information Form’ and ‘Attitude Scale about Euthanasia, Death and Dying Patients (DAS)’ were used as data collection tool. Ethical consideration: Written permissions were received from the ‘Noninterventional Clinical Researches Ethics Board’ of authors’ university and education councils of each hospital. Informed consent was obtained from participants. Findings: It is found that there are statistically significant difference among the factors of marital status, having a child, years of experience, bereavement experience, affected by working with dying patient, definition of euthanasia, views about patients who are appropriate for euthanasia, views about patients who desire to die and feeling need for counselling on these concepts according to the mean total score of nurses’ attitudes about euthanasia, death and dying patient (p < 0.05). Conclusion: The results indicate that nurses are negatively affected to face the concepts of death, euthanasia and work with dying patient. This is reflected in their attitude. In order to gain positive attitude towards death, dying patient and euthanasia, the implementation of training and consulting services to nurses at appropriate intervals during both education and professional life are required.
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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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Zenz J. Response to LiPuma and DeMarco's Article on "Hastening Death". Health Serv Insights 2017; 10:1178632917710017. [PMID: 28615954 PMCID: PMC5462549 DOI: 10.1177/1178632917710017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 02/13/2017] [Indexed: 11/17/2022] Open
Abstract
The paper “Palliative care and patient autonomy: moving beyond prohibitions against hastening death” by LiPuma and DeMarco deals with an aspect of end of life care which is the source of considerable disagreement. It is important to emphasize that autonomy is not the unique feature for end of life care. There is always a medical and ethical commitment to care, i.e. beneficence and nonmaleficence. All of these aspects have to be taken into account when treating patients at the very end of life. There is considerable scientific proof indicating that most patients and families can experience a death in dignity when being cared for in palliative care or hospice units.
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Terkamo-Moisio A, Kvist T, Kangasniemi M, Laitila T, Ryynänen OP, Pietilä AM. Nurses’ attitudes towards euthanasia in conflict with professional ethical guidelines. Nurs Ethics 2016; 24:70-86. [DOI: 10.1177/0969733016643861] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Despite the significant role of nurses in end-of-life care, their attitudes towards euthanasia are under-represented both in the current literature and the controversial debate that is ongoing in several countries. Research questions: What are the attitudes towards euthanasia among Finnish nurses? Which characteristics are associated with those attitudes? Research design: Cross-sectional web-based survey. Participants and research context: A total of 1003 nurses recruited via the members’ bulletin of the Finnish Nurses Association and social media. Ethical considerations: Ethical approval was obtained from the Committee on Research Ethics of the university to which the authors were affiliated. Findings: The majority (74.3%) of the participants would accept euthanasia as part of Finnish healthcare, and 61.8% considered that Finland would benefit from a law permitting euthanasia. Most of the nurses (89.9%) thought that a person must have the right to decide on his or her own death; 77.4% of them considered it likely that they would themselves make a request for euthanasia in certain situations. Discussion: The value of self-determination and the ability to choose the moment and manner of one’s death are emphasized in the nurses’ attitudes towards euthanasia. Conclusion: A continuous dialogue about euthanasia and nurses’ shared values is crucial due to the conflict between nurses’ attitudes and current ethical guidelines on nursing.
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Affiliation(s)
| | | | | | | | | | - Anna-Maija Pietilä
- University of Eastern Finland, Finland; Social and Health Care Services, Finland
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