Euthanasia and assisted suicide in Dutch hospitals: the role of nurses.
OBJECTIVE
To report a study on the role of nurses in euthanasia and physician-assisted suicide in hospitals, conducted as part of a wider study on the role of nurses in medical end-of-life decisions.


BACKGROUND
Issues concerning legislation and regulation with respect to the role of nurses in euthanasia and physician-assisted suicide gave the Dutch Minister for Health reason to commission a study on the role of nurses in medical end-of-life decisions in hospitals, homecare and nursing homes.


METHODS
A questionnaire was sent in 2003 to 692 nurses employed in 73 hospital locations. The response suitable for analysis was from 532 (76.9%) nurses. Data were quantitatively analysed using spss version 11.5 for Windows.


RESULTS
In almost half of the cases (45.1%), the nurse was the first with whom patients discussed their request for euthanasia or physician-assisted suicide. Consultations between physicians and nurses quite often took place (78.8%). In several cases (15.4%), nurses themselves administered the euthanatics with or without a physician. It is not self-evident that hospitals have guidelines concerning euthanasia/physician-assisted suicide.


CONCLUSIONS
In the decision-making process, the consultation between the physician and the nurse needs improvement. In administering the euthanatics, physicians should take responsibility and should not leave these actions to nurses. Guidelines may play an important role to improve the collaboration between physicians and nurses and to prevent procedural, ethical and legal misunderstandings.


CONCLUSIONS
Nurses in clinical practice are often closely involved in the last stage of a person's life. Consequently, they are often confronted with caring for patients requesting euthanasia or physician-assisted suicide. The results provide relevant information and may help nurses in defining their role in euthanasia and physician-assisted suicide, especially in case these practices should become legalised.
van Bruchem-van de Scheur
G G
GG
Department of Health, Ethics and Society, Maastricht University, Maastricht, The Netherlands. A.vanBruchem@zw.unimaas.nl
van der Arend
Arie J G
AJ
Huijer Abu-Saad
Huda
H
van Wijmen
Frans C B
FC
Spreeuwenberg
Cor
C
Ter Meulen
Ruud H J
RH
D000328:Adult; D032722:Advance Care Planning / Q000941:ethics / Q000458:organization & administration; D001291:Attitude of Health Personnel; D003142:Communication; D003657:Decision Making; D005065:Euthanasia / Q000941:ethics / Q000331:legislation & jurisprudence / Q000523:psychology; D005260:Female; D006291:Health Policy / Q000331:legislation & jurisprudence; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D024802:Nurse's Role / Q000523:psychology*; D009723:Nurse-Patient Relations; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000941:ethics / Q000458:organization & administration* / Q000523:psychology*; D016134:Organizational Policy; D019555:Physician-Nurse Relations; D017410:Practice Guidelines as Topic; D036301:Qualitative Research; D017236:Suicide, Assisted / Q000941:ethics / Q000331:legislation & jurisprudence / Q000523:psychology; D011795:Surveys and Questionnaires