De Hert Marc, Van Bos Liesbet, Sweers Kim, Wampers Martien, De Lepeleire Jan, Correll Christophe U
University Psychiatric Centre Z.org KU Leuven, KU Leuven Department of Neurosciences, Leuven, Belgium.
Academic Center for General Practice, Leuven, Belgium.
PLoS One. 2015 Dec 23;10(12):e0144749. doi: 10.1371/journal.pone.0144749. eCollection 2015.
When psychiatric patients express a wish for euthanasia, this should first and foremost be interpreted as a cry for help. Due to their close day-to-day relationship, psychiatric nurses may play an important and central role in responding to such requests. However, little is known about nurses' attitudes towards euthanasia motivated by unbearable mental suffering.
The aim of this study was to provide insight into the attitudes and actions taken by psychiatric nurses when confronted with a patient's euthanasia request based on unbearable mental suffering (UMS).
A questionnaire was sent to 11 psychiatric hospitals in the Flemish part of Belgium.
The overall response rate was 70% (N = 627). Psychiatric nurses were frequently confronted with a request for euthanasia, either directly (N = 329, 53%) or through a colleague (N = 427, 69%). A majority (N = 536, 84%) did not object to euthanasia in a psychiatrically ill population with UMS. Confounding factors were the psychiatric diagnosis and the type of ward where the nurses were working. Most participants acknowledged a lack of knowledge and skills to adequately address the euthanasia request (N = 434, 71%). Nearly unanimously (N = 618, 99%), study participants indicated that dealing with euthanasia requests and other end-of-life issues should be part of the formal training of nurses.
The results highlight the need for ethically sound and comprehensive provision of care. Psychiatric nurses play an important role in dealing with the complex issue of requests for euthanasia. There is also a need for education, training and clear guidelines on the level of health care organizations.
当精神病患者表达安乐死的愿望时,这首先应被视为一种求助呼声。由于精神病护士与患者日常关系密切,他们在回应此类请求时可能发挥重要且核心的作用。然而,对于护士对因无法忍受的精神痛苦而产生的安乐死的态度,我们知之甚少。
本研究旨在深入了解精神病护士在面对基于无法忍受的精神痛苦(UMS)的患者安乐死请求时的态度和采取的行动。
向比利时弗拉芒地区的11家精神病医院发送了一份问卷。
总体回复率为70%(N = 627)。精神病护士经常面临安乐死请求,要么是直接收到(N = 329,53%),要么是通过同事得知(N = 427,69%)。大多数人(N = 536,84%)不反对对患有UMS的精神病患者实施安乐死。混杂因素包括精神病诊断以及护士工作的病房类型。大多数参与者承认缺乏充分应对安乐死请求的知识和技能(N = 434,71%)。几乎全体一致(N = 618,99%),研究参与者表示处理安乐死请求和其他临终问题应成为护士正规培训的一部分。
研究结果凸显了进行符合伦理且全面护理的必要性。精神病护士在处理安乐死请求这一复杂问题中发挥着重要作用。在医疗保健组织层面也需要开展教育、培训并制定明确的指导方针。