“It’s intense, you know.” Nurses’ experiences in caring for patients requesting euthanasia

Abstract

The Belgian Act on Euthanasia came into force on 23 September 2002, making Belgium the second country--after the Netherlands--to decriminalize euthanasia under certain due-care conditions. Since then, Belgian nurses have been increasingly involved in euthanasia care. In this paper, we report a qualitative study based on in-depth interviews with 18 nurses from Flanders (the Dutch-speaking part of Belgium) who have had experience in caring for patients requesting euthanasia since May 2002 (the approval of the Act). We found that the care process for patients requesting euthanasia is a complex and dynamic process, consisting of several stages, starting from the period preceding the euthanasia request and ending with the aftercare stage. When asked after the way in which they experience their involvement in the euthanasia care process, all nurses described it as a grave and difficult process, not only on an organizational and practical level, but also on an emotional level. "Intense" is the dominant feeling experienced by nurses. This is compounded by the presence of other feelings such as great concern and responsibility on the one hand, being content in truly helping the patient to die serenely, and doing everything in one's power to contribute to this; but also feeling unreal and ambivalent on the other hand, because death is arranged. Nurses feel a discrepancy, because although it is a nice death, which happens in dignity and with respect, it is also an unnatural death. The clinical ethical implications of these findings are discussed.

Communication in nursing care for patients requesting euthanasia: a qualitative study

“…(2) A euthanasia care process is a very intense process for everyone involved, not only on a practical, organisational level, but also on an emotional level, requiring coping strength (De Bal et al. 2008, Denier et al. 2009).…”

Moral distress

“…30 As Jameton himself acknowledges, similar concerns about the ambiguity of the nursing role and the limits that it places on nurses' moral agency have been and continue to be discussed in the broader nursing ethics literature. 34,35 Some authors also take issue with what they see as Jameton's inadequate attention to the relationship between personal and professional morality. They argue that professional responsibilities necessarily confer some level of MD on nurses because of tensions between one's personal moral integrity and one's professional role.…”

Social-cultural factors in end-of-life care in Belgium: A scoping of the research literature

“…[82][83][84] The role of nurses in the request, performance and aftermath of euthanasia, as well as their opinions on this MELD, was a common topic. 12,31,[44][45][46]55,[84][85][86] Nurses played an important role throughout the process of euthanasia from the initial request to family support after a decision was made. 12,31,[44][45][46]55,[85][86][87] One study looked at nurses involvement in do-not-resuscitate decisions 88 and another at their involvement in decisions related to administration of artificial nutrition or hydration in patients with dementia.…”