The role of nurses in euthanasia and physician-assisted suicide in The Netherlands

Abstract

The results show substantial differences between the intramural sector (hospitals and nursing homes) and the extramural sector (home care), which are probably linked to the organisational structure of the institutions. Consultation between physicians and nurses during the decision-making process needs improvement, particularly in home care. Some nurses had administered euthanatics, although this task is by law exclusively reserved to physicians.

The role of nurses in physician-assisted deaths in Belgium

“…Similar findings have been reported in other countries. 14,15 In our study, administration of the life-ending drugs by the nurse occurred more frequently in the cases without an explicit request from the patient than in the cases of euthanasia. Previous studies have shown that nurses believe an explicit request from the patient is required when accepting an assisting role in dying.…”

“…It is also unknown whether our findings are generalizable to practices elsewhere in the world, although the studied practices and legal prohibition of nurses' involvement in administering life-ending drugs exists worldwide. [1][2][3][4][5]10,11,14,15,22,33,34 Conclusion By administering life-ending drugs at the physician's request in some cases of euthanasia, and even more so in cases without an explicit request from the patient, the nurses in our study operated beyond the legal margins of their profession. Future research should closely monitor and examine the involvement of nurses in these practices nationally and internationally to allow comparisons between countries with and without euthanasia legislation.…”

“…[1][2][3][4][5] To translate this to nursing practice, we made adaptations to the questionnaire on the basis of one used in a Dutch study about the involvement of nurses in euthanasia 14 and by testing the questionnaire extensively. Content validity was established through expert review and through an in-depth discussion by a focus group.…”

“…[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. 16 There are no further explicit stipulations determining the role of nurses in euthanasia.…”

“…Reports from nurses in these jurisdictions are scarce, apart from some that are limited to particular settings, or lack details about their involvement. 13,14 We conducted this study to investigate the involvement of nurses in Flanders, Belgium, in the decision-making and in the preparation and administration of life-ending drugs with, or without, a patient's explicit request. We also examined patient-and nurse-related factors associated with the involvement of nurses in these deaths.…”