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EEG and autonomic habituation were studied during sleep stages 2 and REM. and during awake. Repeated presentations of the same stimulus to the same subjects within sleep stages and when awake permitted evaluation of habituation between tone sets within stag 2, REM, and awake, and from sleep to awake. Forty‐six subjects were exposed to 800 Hz. 75 dB, 1‐ or 2‐sec tones, presented in sets of 20 tones. During steep, there was no habituation of the EEC response. Habituation occurred for both FPR and HRR during stage 2, with no evidence of within‐stage. between tone set habituation. No significant habituation occurred during REM for HRR or FPR. Evoked skin resistance responses were rare during both stage 2 and RKM. In the awake state, HRR was unresponsive but all other variables showed habituation. Tones presented during the night had no effect on the awake response.

Background: Legal assisted dying is a rare event, but as legalisation expands, requests for it will likely increase, and the nurse most often receives the informal, initial request. Objectives: To assess the effects of attitude in interaction with normative and control beliefs on an intention to respond to a request for legal assisted dying. Ethical considerations: The study had the lead author’s institutional ethics approval, and participants were informed that participation was both anonymous and voluntary. Methodology: This was a cross-sectional correlational study of 377 Australian registered nurses who completed an online survey. Generalised linear modelling assessed the effects of independent variables against intended responses to requests for legal assisted dying. Results: Compared to nurses who did not support legal assisted dying, nurses who did had stronger beliefs in patient rights, perceived social expectations to refer the request and stronger control in that intention. Nurses who did not support legal assisted dying had stronger beliefs in ethics of duty to the patient and often held dual intentions to discuss the request with the patient but also held an intention to deflect the request to consideration of alternatives. Discussion: This study advances the international literature by developing quantified models explaining the complexity of nurses’ experiences with requests for an assisted death. Attitude was operationalised in interaction with other beliefs and was identified as the strongest influence on intentions, but significantly moderated by ethical norms. Conclusion: The complex of determinants of those intentions to respond to requests for an assisted death suggests they are not isolated from each other. Nurses might have distinct intentions, but they can also hold multiple intentions even when they prioritise one. These findings present opportunities to prepare nurses in a way that enhances moral resilience in the face of complex moral encounters.

Background & objectives: Identifying the impacts of COVID-19 on patients’ and practitioners’ access to legal assisted dying and euthanasia (AD&E) services is vital to informing service continuity in an ongoing pandemic. Methods: An anonymous online survey collected qualitative and quantitative data from health practitioners and agencies providing legal AD&E services ( n = 89), complemented by semi-structured interviews with 18 survey respondents who volunteered. Results: Following governments’ responses to the dynamic pandemic context, rates of AD&E inquiries and requests fluctuated across and within jurisdictions, based on a complex interaction of factors affecting patient access to AD&E agencies and assessors as services were disrupted. Service flexibility and nimbleness became key elements in continuing service availability and included calculated ‘rule-breaking’ considered justifiable to adhere to established bioethics. Making innovative adjustments to usual practice led to reviewing the effectiveness of AD&E services and laws, resulting in providers now improving services and lobbying for legislative change.

AimsTo explore the intentions of nurses to respond to requests for legal assisted‐dying.BackgroundAs more Western nations legalize assisted‐dying, requests for access will increase across clinical domains. Understanding the intentions of nurses to respond to such requests is important for the construction of relevant policy and practice guidelines.DesignMixed‐methods.Data SourcesA total of 45 Australian nurses from aged, palliative, intensive, or cancer care settings surveyed in November 2018.MethodQ‐methodology studying nurses’ evaluations of 49 possible responses to a request for a hastened death. Data consisted of rank‐ordered statements analysed by factor analysis with varimax rotation.FindingsFour distinct types of intentions to respond to requests for assisted‐dying: a) refer and support; b) object to or deflect the request; c) engage and explore the request; or d) assess needs and provide information.ConclusionThe findings underscore the complexity of intentionality in assisted‐dying nursing practice and differences from other forms of end‐of‐life care, particularly regarding patient advocacy and conscientious objection. This study enables further research to explore determinants of these intentions. It can also assist the development of professional guidance by linking policy and clinical intentions.ImpactIdentified a basic range of nurses’ intentions to respond to requests for assisted‐dying, as there was no evidence at present. Developed a fourfold typology of intentions to respond with most nurses intending to engage in practices that support the requestor and sometimes the request itself. A minority would object to discussing the request. The relatively low level of advocacy within the intended responses selected also is distinctly different from other end‐of‐life care research findings. This research could assist nursing associations in jurisdictions transitioning to legal assisted‐dying to develop guidance ways nurses can frame their responses to requests.

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