Attitudes of nurses to euthanasia

Abstract

Active euthanasia remains unlawful in the UK, but several high profile cases, such as that of Cox (Regina v Cox, 1992) and Pretty (House of Lords, 2001) have maintained interest in the subject. Attempts were also made to change the law in February 2003, when Lord Joffe introduced an assisted suicide bill in the House of Lords. Euthanasia is an important issue for practising nurses as research and technological advancesa llow patientst o be resuscitated,given new treatments and kept alive using artificial means. Nurses are the largest group of health workers in the United Kingdom (UK) whose role encompasses the care of people at the end of life and thus, the overall aim of this thesis was to investigate the attitudes of UK nurses to active voluntary euthanasia (AVE), that is taking deliberate measures to end the life of a terminally ill patient. Two further aims were; to investigate similarities and differences in attitudes to euthanasia of nurses working in differing clinical areas, and to evaluate the impact of research design and data collection methods on attitudes towards euthanasia. To achieve these aims, four studies were carried out. Study I used focus groups to identify the concepts registered nurses consider to be important in the euthanasia debate. Content analysis of the data revealed categories and sub-categories to be used as stimulus materials in future studies. In Study 2, an anonymous Internet based questionnaire consisting of questions derived from data collected in Study 1, the Euthanasia Ideology Scale (Adams, Bueche, & Schvaneveldt, 1978), and the Moral Judgment Test (Lind,1999) was used to survey nurses' attitudes. Analysis of the data revealed three factors that UK nurses consider important in the euthanasia debate; a) nurses' concerns about administering euthanasia; b) patient control and the alleviation of suffering; and c) conditions for administering euthanasia. Also using the data obtained in Study I to develop aQ set for sorting, Study 3 used Q methodology to explore the attitudes of intensive care, hospice and nursing home nurses. Three understandings of nurses' attitudes to euthanasia were demonstrated in the findings; a) cautiously supportive, b) against euthanasia, and c) supportive of patient autonomy and some differences observed based upon clinical speciality. To investigate this further, Study 4 applied the theory of planned behaviour, to focus specifically on the influence of clinical speciality on nurses' attitudes. While a positive attitude to euthanasia was the strongest predictor of intentions,differences were found across clinical specialities and were influenced by the strength of the nurses' religious beliefs. The suitability of the methods for investigating ethical questions empirically are evaluated and recommendations made for further research