Schwarz Judith Kennedy
New York University, New York, USA.
J Nurs Scholarsh. 2003;35(4):377-84. doi: 10.1111/j.1547-5069.2003.00377.x.
To explore how nurses experience and respond to patients' requests for assistance in dying (AID).
A phenomenological study of 10 self-selected nurses.
Four major themes: Being Open to Hear and Hearing; Interpreting and Responding to the Meaning; Responding to Persistent Requests for AID, and Reflections. When faced with persistent requests for AID, participants provided a continuum of interventions: refusal, providing palliative care that might secondarily hasten dying, respecting and not interfering with patients' or families' plans to hasten dying, and providing varying types and degrees of direct AID. Their responses were context-driven rather than rule-mandated, and they drew a distinction between secondarily hastening and directly causing death.
Few nurses in this study unequivocally agreed or refused to directly help a patient die. Most struggled alone and in silence to find a morally and legally acceptable way to help patients who persisted in requesting AID. Regardless of how they responded, many described feelings of conflict, guilt, and moral distress.
探讨护士如何体验和应对患者的协助死亡请求。
对10名自行选择的护士进行现象学研究。
四个主要主题：愿意倾听与倾听；解读并回应意义；回应持续的协助死亡请求，以及反思。面对持续的协助死亡请求时，参与者提供了一系列干预措施：拒绝、提供可能间接加速死亡的姑息治疗、尊重且不干涉患者或家属加速死亡的计划，以及提供不同类型和程度的直接协助死亡。他们的反应是由具体情境驱动而非规则强制的，并且他们区分了间接加速死亡和直接导致死亡。
本研究中很少有护士明确同意或拒绝直接帮助患者死亡。大多数人独自默默挣扎，以找到一种道德和法律上可接受的方式来帮助那些坚持请求协助死亡的患者。无论他们如何回应，许多人都描述了冲突、内疚和道德困扰的感觉。
