Factors related to the involvement of nurses in medical end-of-life decisions in Belgium: A death certificate study

Knowledge, Attitudes and Practices Regarding the Limitation of Therapeutic Efforts by Health Personnel at a University Hospital

“…es un factor determinante en el tipo de atención y la forma como se enfrenta el cuidado de los pacientes (24)(25)(26). Por esto, al momento de aproximarse a los factores que influyen en la toma de decisiones de LET en personal de la salud, una previa experiencia personal o familiar a este tipo de situaciones se convierte en un elemento crucial que transversaliza las actitudes y las prácticas en torno al tema (13,18,27).…”

“…Al respecto, un estudio realizado en Bélgica encontró que la participación de enfermería en decisiones clínicas era más frecuente en hogares geriátricos que en hospitales y esta participación fue más frecuente cuando los médicos tenían la intención de tomar decisiones de LET (27).…”

The role of nurses in physician-assisted deaths in Belgium

“…In a survey of physicians in Belgium, only half of those who had had cases of euthanasia reported that they had involved nurses in their decision-making. 9 In the study by Chambaere and colleagues, physicians reported having discussed the decision with the nurses in 54% of the cases of euthanasia or assisted suicide and in 40% of the cases of assisted death without the patient's explicit request. 17 In our study, the involvement of nurses was restricted mainly to informing the physician about the patient's condition or the patient's and relatives' wishes.…”

“…7,9,17,22 Nevertheless, uncertainty remained about the understanding by the nurses of the act that they performed. In our study, nurses did administer life-ending drugs with the recognition that the death of the patient was intended.…”

“…6 However, physicians worldwide have reported that nurses are also involved in these medical practices, mostly in the decision-making and sometimes in the administration of the life-ending drugs. [1][2][3][7][8][9] Critical care, 10 oncology 11 and palliative care nurses 12,13 have confirmed this by reporting their own involvement, particularly in cases of euthanasia. 14,15 In Belgium, the law permits physicians to perform euthanasia under strict requirements of due care, one of which is that they must discuss the request with the nurses involved.…”