van Bruchem-van de Scheur G G, van der Arend Arie J G, Huijer Abu-Saad Huda, van Wijmen Frans C B, Spreeuwenberg Cor, Ter Meulen Ruud H J
Department of Health, Ethics and Society, Maastricht University, Maastricht, The Netherlands.
J Clin Nurs. 2008 Jun;17(12):1618-26. doi: 10.1111/j.1365-2702.2007.02145.x.
To report a study on the role of nurses in euthanasia and physician-assisted suicide in hospitals, conducted as part of a wider study on the role of nurses in medical end-of-life decisions.
Issues concerning legislation and regulation with respect to the role of nurses in euthanasia and physician-assisted suicide gave the Dutch Minister for Health reason to commission a study on the role of nurses in medical end-of-life decisions in hospitals, homecare and nursing homes.
A questionnaire was sent in 2003 to 692 nurses employed in 73 hospital locations. The response suitable for analysis was from 532 (76.9%) nurses. Data were quantitatively analysed using spss version 11.5 for Windows.
In almost half of the cases (45.1%), the nurse was the first with whom patients discussed their request for euthanasia or physician-assisted suicide. Consultations between physicians and nurses quite often took place (78.8%). In several cases (15.4%), nurses themselves administered the euthanatics with or without a physician. It is not self-evident that hospitals have guidelines concerning euthanasia/physician-assisted suicide.
In the decision-making process, the consultation between the physician and the nurse needs improvement. In administering the euthanatics, physicians should take responsibility and should not leave these actions to nurses. Guidelines may play an important role to improve the collaboration between physicians and nurses and to prevent procedural, ethical and legal misunderstandings.
Nurses in clinical practice are often closely involved in the last stage of a person's life. Consequently, they are often confronted with caring for patients requesting euthanasia or physician-assisted suicide. The results provide relevant information and may help nurses in defining their role in euthanasia and physician-assisted suicide, especially in case these practices should become legalised.
报告一项关于护士在医院安乐死及医生协助自杀中所起作用的研究，该研究是关于护士在医疗临终决策中作用的更广泛研究的一部分。
关于护士在安乐死及医生协助自杀中作用的立法和监管问题，促使荷兰卫生部长委托开展一项关于护士在医院、家庭护理和养老院医疗临终决策中作用的研究。
2003年向73家医院的692名护士发放了问卷。适合分析的回复来自532名（76.9%）护士。使用Windows版SPSS 11.5对数据进行定量分析。
在近一半的案例中（45.1%），护士是患者首个讨论安乐死或医生协助自杀请求的对象。医生和护士之间经常进行协商（78.8%）。在一些案例中（15.4%），护士自行或在医生在场的情况下实施了安乐死药物注射。医院是否有关于安乐死/医生协助自杀的指导方针并不明确。
在决策过程中，医生与护士之间的协商需要改进。在实施安乐死药物注射时，医生应承担责任，不应将这些行为留给护士。指导方针可能在改善医生与护士之间的合作以及防止程序、伦理和法律误解方面发挥重要作用。
临床实践中的护士经常密切参与一个人生命的最后阶段。因此，他们经常面临照顾请求安乐死或医生协助自杀的患者的情况。研究结果提供了相关信息，可能有助于护士明确自己在安乐死及医生协助自杀中的角色，特别是在这些做法合法化的情况下。
