St. Mary's Research Centre, Canada; McGill University, Canada.
University of Ottawa, Canada; St. Mary's Research Centre, Canada.
Nurs Ethics. 2018 Dec;25(8):955-972. doi: 10.1177/0969733016679468. Epub 2016 Dec 28.
: Legislative changes are resulting in assisted death as an option for people at the end of life. Although nurses' experiences and perspectives are underrepresented within broader ethical discourses about assisted death, there is a small but significant body of literature examining nurses' experiences of caring for people who request this option.
: To synthesize what has been learned about nurses' experiences of caring for patients who request assisted death and to highlight what is morally at stake for nurses who undertake this type of care.
: Qualitative meta-synthesis.
: Six databases were searched: CINAHL, Medline, EMBASE, Joanna Briggs Institute, PsycINFO, and Web of Science. The search was completed on 22 October 2014 and updated in February 2016. Of 879 articles identified from the database searches, 16 articles were deemed relevant based on inclusion criteria. Following quality appraisal, 14 studies were retained for analysis and synthesis.
: The moral experience of the nurse is (1) defined by a profound sense of responsibility, (2) shaped by contextual forces that nurses navigate in everyday end-of-life care practice, and (3) sustained by intra-team moral and emotional support.
: The findings of this synthesis support the view that nurses are moral agents who are deeply invested in the moral integrity of end-of-life care involving assisted death. The findings further demonstrate that to fully appreciate the ethics of assisted death from a nursing standpoint, it is necessary to understand the broader constraints on nurses' moral agency that operate in everyday end-of-life care.
: Research ethics board approval was not required for this synthesis of previously published literature.
: In order to understand how to enact ethical practice in the area of assisted death, the moral experiences of nurses should be investigated and foregrounded.
立法的改变使得协助死亡成为生命末期患者的一种选择。尽管护士在关于协助死亡的更广泛伦理讨论中代表性不足，但仍有一小部分文献研究了护士照顾请求这种选择的患者的经验。
综合了解护士照顾请求协助死亡患者的经验，并强调承担这种护理的护士在道德上的利害关系。
定性元分析。
六个数据库进行了检索：CINAHL、Medline、EMBASE、Joanna Briggs Institute、PsycINFO 和 Web of Science。搜索于 2014 年 10 月 22 日完成，并于 2016 年 2 月进行了更新。从数据库搜索中确定了 879 篇文章，根据纳入标准，有 16 篇文章被认为是相关的。经过质量评估，保留了 14 项研究进行分析和综合。
护士的道德体验是（1）由一种深刻的责任感定义的，（2）由护士在日常临终关怀实践中应对的背景力量塑造的，（3）由团队内部的道德和情感支持维持的。
这一综合研究的结果支持了这样一种观点，即护士是道德代理人，他们深深地投入到涉及协助死亡的临终关怀的道德完整性中。研究结果进一步表明，要从护理角度全面了解协助死亡的伦理问题，有必要了解在日常临终关怀中对护士道德代理权的更广泛限制。
由于这是对先前已发表文献的综合研究，因此不需要研究伦理委员会的批准。
为了理解如何在协助死亡领域实施伦理实践，应该调查和突出护士的道德体验。
