Nursing staff wants to be involved in decision making on euthanasia

Nurses and health care workers believe they should not be left out of decision making on euthanasia. A small group also mistakenly believes they are allowed to administer euthanasia drugs. These findings were published in an article by researchers from the Netherlands Institute for Health Services Research (NIVEL) and VU University Medical Center Amsterdam (VUmc) in the journal Patient Education and Counseling.

Most nurses and health care workers (69%) believe that when a doctor receives a euthanasia request from a patient, this should be discussed with the nursing staff who have had regular contact with the patient. In addition, 38% indicated they have sometimes been the first person with whom a patient has discussed their wish to have euthanasia. About a third of them also reported informing a doctor about a patient’s euthanasia request on at least one occasion. Only 3% reported ever having refused to participate in decision making regarding euthanasia.
 
Beliefs
Nurses and health care workers with religious or other beliefs that are important to their attitude towards end-of-life decisions are more likely to find that doctors should discuss a patient’s euthanasia request with them. This is true more often for those who work in hospitals and home health care services than for those who work in nursing and care homes.
 
Preparations for euthanasia
Nurses and health care workers are seldom present when euthanasia takes place. Only 7% reported ever having been present during euthanasia in order to assist a doctor. However, it is interesting to note that another 7% believe they are allowed to administer the euthanasia drugs themselves. Very few (3% or less) indicated they ever picked up the drugs from the pharmacy, prepared or connected the intravenous drip, or dissolved the drugs, even though professional guidelines allow for this.
 
Communication
NIVEL programme director Professor Anneke Francke: “Because they’re in communication with patients and their families as well as doctors, nurses and health care workers can contribute to decision making when a patient requests euthanasia. However, I find it surprising that there are still those who believe they are allowed to administer the drugs. Professional guidelines and the euthanasia act are clear about this: only doctors are allowed to do this, and only under strict conditions. It remains important for vocational training and professional development courses for nurses and health care workers to continue to provide clear information about the ethical and professional boundaries with respect to euthanasia.”
 
Research
The study was carried out among members of the NIVEL Nursing Staff Panel. For the study, 587 nurses and health care workers working in hospitals, home health care services, and nursing and care homes filled in a written questionnaire.

Funding
Ministry of Health, Welfare and Sport, KNMG
 
Cooperating partner
VUmc