Bendiane M K, Bouhnik A-D, Galinier A, Favre R, Obadia Y, Peretti-Watel P
INSERM U, Université Aix Marseille, IRD, UMR, ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, France.
J Med Ethics. 2009 Apr;35(4):238-44. doi: 10.1136/jme.2008.025296.
Hospital nurses are frequently the first care givers to receive a patient's request for euthanasia or physician-assisted suicide (PAS). In France, there is no consensus over which medical practices should be considered euthanasia, and this lack of consensus blurred the debate about euthanasia and PAS legalisation. This study aimed to investigate French hospital nurses' opinions towards both legalisations, including personal conceptions of euthanasia and working conditions and organisation.
A phone survey conducted among a random national sample of 1502 French hospital nurses. We studied factors associated with opinions towards euthanasia and PAS, including contextual factors related to hospital units with random-effects logistic models.
Overall, 48% of nurses supported legalisation of euthanasia and 29%, of PAS. Religiosity, training in pallative care/pain management and feeling competent in end-of-life care were negatively correlated with support for legalisation of both euthanasia and PAS, while nurses working at night were more prone to support legalisation of both. The support for legalisation of euthanasia and PAS was also weaker in pain treatment/palliative care and intensive care units, and it was stronger in units not benefiting from interventions of charity/religious workers and in units with more nurses.
Many French hospital nurses uphold the legalisation of euthanasia and PAS, but these nurses may be the least likely to perform what proponents of legalisation call "good" euthanasia. Improving professional knowledge of palliative care could improve the management of end-of-life situations and help to clarify the debate over euthanasia.
医院护士常常是最早收到患者安乐死或医生协助自杀请求的护理人员。在法国,对于哪些医疗行为应被视为安乐死尚无共识,这种缺乏共识的情况模糊了关于安乐死和医生协助自杀合法化的辩论。本研究旨在调查法国医院护士对这两种合法化的看法,包括对安乐死的个人观念以及工作条件和组织情况。
对1502名法国医院护士进行全国随机抽样电话调查。我们使用随机效应逻辑模型研究与对安乐死和医生协助自杀看法相关的因素,包括与医院科室相关的背景因素。
总体而言,48%的护士支持安乐死合法化,29%的护士支持医生协助自杀合法化。宗教信仰、姑息治疗/疼痛管理培训以及在临终关怀方面感到胜任与对安乐死和医生协助自杀合法化的支持呈负相关,而夜间工作的护士更倾向于支持两者合法化。在疼痛治疗/姑息治疗科室和重症监护病房,对安乐死和医生协助自杀合法化的支持也较弱,而在没有慈善/宗教工作者干预的科室以及护士较多的科室,支持力度更强。
许多法国医院护士支持安乐死和医生协助自杀合法化,但这些护士可能最不可能实施合法化支持者所称的“良好”安乐死。提高姑息治疗的专业知识可以改善临终情况的管理,并有助于澄清关于安乐死的辩论。