Medical end-of-life decisions: experiences and attitudes of Belgian pediatric intensive care nurses.
OBJECTIVE
To investigate Belgian pediatric intensive care nurses' involvement in and attitudes toward medical end-of-life decisions with a possible or certain life-shortening effect.


METHODS
Questionnaires were distributed to 141 nurses working in 5 of the 7 pediatric intensive care units in Belgium. Nurses were asked to recall the last child in their care whose treatment involved an end-of-life decision and to describe anonymously their involvement in the decision. Attitudes were ascertained by means of statements and a Likert scale.


RESULTS
Questionnaires were completed by 89 nurses (63%). During the preceding 2 years, 76 (85%) had cared for at least 1 child for whom a medical end-of-life decision had been made. Nurses were involved in initiating the decision in 17% of cases, participated in decision making in 50%, and played a role in carrying out the decision in 90%. Only 6% of nurses found it always ethically wrong to hasten the death of a child by administering lethal drugs; most nurses (78%) reported they were prepared to cooperate in administering life-ending drugs in some cases. Most (89%) favored adapting the law, making life termination of children legally possible in certain cases.


CONCLUSIONS
Belgian pediatric intensive care nurses are often involved in carrying out medical end-of-life decisions, including administration of life-ending drugs, whereas their participation in decision making is more limited. Most think that the current euthanasia law should be extended to minors so that administering life-ending drugs would be possible for terminally ill children in specific circumstances.
Inghelbrecht
Els
E
End-of-Life Care Research Group, Department of Public Health, Vrije Universiteit Brussel, and pediatric intensive care unit, University Hospital Brussels, Brussels, Belgium. Els.Inghelbrecht@vub.ac.be
Bilsen
Johan
J
Pereth
Heidi
H
Ramet
José
J
Deliens
Luc
L
D000328:Adult; D001291:Attitude of Health Personnel; D001530:Belgium; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D004522:Educational Status; D005065:Euthanasia / Q000523:psychology*; D028601:Euthanasia, Active / Q000523:psychology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology*; D012067:Religion; D012189:Retrospective Studies; D013727:Terminal Care / Q000523:psychology*