Role of nurses in institutional ethics policies on euthanasia.
OBJECTIVE
This paper reports the findings of a survey that investigated whether Flemish Catholic hospitals and nursing homes had developed written ethics policies on euthanasia and how the role of nurses was described in these policies.


BACKGROUND
International research shows undeniably that nurses are confronted with patients requesting euthanasia. Euthanasia has been legal in Belgium since 2002 and in Holland since 2001. Because of the vagueness in formal documents and policies on the role of nurses in euthanasia, there is an increasing need to establish institutional ethics policies that clearly describe the role of nurses in the euthanasia process.


METHODS
We used a cross-sectional descriptive mail questionnaire to survey the general directors of Catholic hospitals and nursing homes in Belgium (Flanders). Data were collected between October 2003 and February 2004.


RESULTS
Of the 298 institutions targeted for survey, 81% of hospitals, 62% of nursing homes returned completed questionnaires. Of these, 79% of the hospitals and 30% of the nursing homes had a written ethics policy on euthanasia. The ethics policies of 87% of the hospitals and 77% of the nursing homes explicitly addressed the role of nurses in the euthanasia process. In the majority of hospitals and nursing homes, the ethics policies addressed the conscientious objections of nurses to euthanasia. Most hospitals and nursing homes voluntarily communicated their ethics policies to the nurses they employed.


CONCLUSIONS
The written ethics policies of most Catholic healthcare institutions give explicit attention to the role of nurses in the euthanasia process. However, the meaning and content of the role of nurses, as indicated in these ethics policies, continue to be an issue. Further research is needed to verify how these policies are actually implemented within the institutions and whether they contribute to better support for nurses and to ethical care for patients.
Centre for Biomedical Ethics and Law, Catholic University of Leuven, Leuven, Belgium. chris.gastmans@med.kuleuven.be
Chris
C
Gastmans
Joke
J
Lemiengre
Bernadette
B
Dierckx de Casterlé
D001291:Attitude of Health Personnel; D001293:Attitude to Death; D001530:Belgium; D002410:Catholicism; D003142:Communication; D003430:Cross-Sectional Studies; D004991:Ethics, Institutional; D004993:Ethics, Nursing; D005065:Euthanasia / Q000941:ethics*; D016519:Hospitals, Religious / Q000941:ethics*; D006801:Humans; D024802:Nurse's Role; D009735:Nursing Homes; D016134:Organizational Policy; D011795:Surveys and Questionnaires