title: Do you agree with the doctor's decision to continue treatment? A scenario-based study of hospital nurses in Italy.
abstract: BACKGROUND
  A lack of social consensus on the duty to comply with a patient's request to forgo treatment was reported in Italy, but little is known about the nurses' attitudes regarding this issue.
  
  
  METHODS
  Questionnaire including two clinical scenarios regarding doctor's decision to not comply with a competent patient's request to forgo treatment was administered to all nurses (n = 487) of an Italian medium-sized hospital.
  
  
  RESULTS
  Eighty-five percent of nurses completed the study. Although 83% of participants supported a general right to self-determination, around 40% of them agreed with the doctor's decision in both scenarios. The multivariate analyses adjusted for gender, age, length of professional experience, and care setting showed that the agreement with the doctor's decision was significantly associated with nurses' personal background beliefs about self-determination and quality of life.
  
  
  CONCLUSIONS
  Many nurses have difficulty in accepting a patient's request to forgo treatment. Increasing ethical reflection and discussion at both educational and professional level, and introducing ethical consultation services would be essential to develop a consistent approach to end-of-life decisions in Italian hospitals.
authors.affiliation: Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Ingravallo
authors.affiliation: Ospedale San Donato, Arezzo, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Sandroni
authors.affiliation: Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: D'Addio
authors.affiliation: UO Epidemiologia Clinica e Descrittiva, Istituto per lo Studio e la Prevenzione Oncologica, Florence, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Miccinesi
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006761:Hospitals; D006801:Humans; D007400:Interprofessional Relations; D007558:Italy; D008297:Male; D008875:Middle Aged; D009726:Nurses; D010820:Physicians; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult