REGISTERED NURSES' ATTITUDES TOWARD AND PRACTICES OF ASSISTED SUICIDE AND PATIENT-REQUESTED EUTHANASIA (DEATH, CANCER).

Description

New England oncology nurses were surveyed regarding their attitudes and practices with respect to assisted suicide and patient-requested euthanasia. A representative sample of oncology nurses in New England was surveyed by mail to determine (1) knowledge and views of assisted suicide and patient-requested euthanasia, (2) effects of various circumstances upon the acceptability of assisted suicide and patient-requested euthanasia, and (3) actual practices at the end of their patients' lives. With a 74% return rate, the analysis was based upon 441 responses. Assisted suicide was defined as providing, at the patient's request, the means for them to end life; patient-requested euthanasia is the administration of medications with the intent of ending the patient's life. Data for nurses were compared to data for a previously-surveyed random sample of New England oncology physicians (n = 180) to determine if the attitudes and practices of nurses were different from those of physicians. Bivariate analysis revealed that while sympathetic views toward end-of-life requests were widespread, physicians had more positive attitudes than nurses. While many practitioners had been exposed to these requests, more physicians had been exposed than nurses. More physicians than nurses assisted their patients' suicides (11% versus 1%); nurses were more likely than physicians to have performed patient-requested euthanasia (4% versus 1%). A series of multivariate analyses revealed that greater religiosity (as defined by how religious the practitioners consider themselves to be and how important religious beliefs are to actions) was the most consistent predictor of favorable attitudes toward assisted suicide and patient-requested euthanasia. Neither professional role (nurse or physician) nor religious affiliation were generally associated with attitudes and practices concerning end-of-life actions. Frequency of requests and positive attitudes were positively associated with action to assist patients' deaths. Nurses frequently consulted with others (particularly physicians) about patient requests for assistance with death, but rarely with one another (including nursing supervisors). These findings show that the policy debate about professional roles in actions that end the lives of patients must be extended beyond physicians to include nurses.

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