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J Med Ethics 34:254-258 doi:10.1136/jme.2006.018507
  • Clinical ethics

The role of nurses in euthanasia and physician-assisted suicide in The Netherlands

  1. G G van Bruchem-van de Scheur1,
  2. A J G van der Arend1,
  3. H Huijer Abu-Saad2,
  4. C Spreeuwenberg3,
  5. F C B van Wijmen1,
  6. R H J ter Meulen4
  1. 1
    Department of Health, Ethics Society, Maastricht University, Maastricht, The Netherlands
  2. 2
    Faculty of Medicine, American University of Beirut, Beirut, Lebanon
  3. 3
    Department of Health Care Studies, Maastricht University, The Netherlands
  4. 4
    Centre for Ethics in Medicine, University of Bristol, UK
  1. Drs G G van Bruchem-van de Scheur, Department of Health Ethics and Philosophy, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands; A.vanBruchem{at}zw.unimaas.nl
  • Received 5 July 2006
  • Revised 15 February 2007
  • Accepted 22 February 2007

Abstract

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

Aim: This paper reports the findings of a study of the role of nurses in euthanasia and physician-assisted suicide, conducted as part of a study of the role of nurses in medical end-of-life decisions. The findings for hospitals, home care and nursing homes are described and compared.

Method: A questionnaire was sent to 1509 nurses, employed in 73 hospitals, 55 home care organisations and 63 nursing homes. 1179 responses (78.1%) were suitable for analysis. The questionnaire was pilot-tested among 106 nurses, with a response rate of 85%.

Results: In 37.0% of cases, the nurse was the first person with whom patients discussed their request for euthanasia or physician-assisted suicide. Consultation between physicians and nurses during the decision-making process took place quite often in hospitals (78.8%) and nursing homes (81.3%) and less frequently in home care situations (41.2%). In some cases (12.2%), nurses administered the euthanatics.

Conclusions: The results show substantial differences between the intramural sector (hospitals and nursing homes) and the extramural sector (home care), which are probably linked to the organisational structure of the institutions. Consultation between physicians and nurses during the decision-making process needs improvement, particularly in home care. Some nurses had administered euthanatics, although this task is by law exclusively reserved to physicians.

Footnotes

  • Funding: This study was funded by the Ministry of Health, Welfare and Sports. The study sponsor approved the study design but was not involved in the data collection, data analysis, data interpretation, writing of the report or the decision to submit the paper for publication. The role of the contact person in the Ministry was restricted to the role of advisor without involvement in the decision-making on any part or aspect of the study.

  • Competing interests: None declared.

  • Ethics approval: Ethics approval was granted by the research ethics committee of the Academic Hospital Maastricht and Maastricht University.