Wilson Associates, 22 Pitt St, Marden, South Australia, Australia.
Pam Oliver Ltd., Research and Evaluation, 1 Newton Rd., Waiheke Island, New Zealand.
Int J Nurs Stud. 2019 Jan;89:116-124. doi: 10.1016/j.ijnurstu.2018.03.012. Epub 2018 Apr 15.
This study investigated New Zealand nurses' views on legalising assisted dying across a range of clinical conditions, nurses' willingness to engage in legal assisted dying, potential deterrents and enablers to such engagement, and nurses' perceptions of the proper role of their professional bodies in relation to legalising assisted dying.
A Bill for legalising assisted dying is currently before the New Zealand parliament. Of the 16 jurisdictions where assisted dying has been specifically legislated, only the Canadian federal statute provides nurses with explicit legal protection for their performance of assisted dying-related tasks. An absence of policy development and planning for safe nursing practice prior to legalisation of assisted dying results in a gap in professional support and guidance.
Exploratory cross-sectional survey.
A self-selected sample of 475 New Zealand nurses responded to an anonymous online survey disseminated through the newsletters and websites of relevant medical and nursing professional bodies. A sub-sample of nurses who expressed support for or ambivalence about legalisation (n = 356): rated their level of support for legalising assisted dying in New Zealand across a range of medical conditions, and their willingness to participate in a range of assisted dying tasks; identified barriers and facilitators to potential participation; and assessed the responsibility of the professional bodies to provide practice supports.
Mixed-method approach using descriptive analysis of quantitative data; qualitative data were analysed thematically.
Nurses supported legalisation at a rate (67%) significantly greater than that of doctors (37%) and for a diverse range of medical conditions. Most supporting nurses were willing to engage in the full range of relevant assisted dying roles. They identified several practical and ethical supports as essential to safe engagement, in particular practice guidelines, specific training, legal protections, clinical supervision and mentoring, and independent review of assisted dying service provision. They saw the facilitation of these supports as primarily the responsibility of their professional bodies.
Nursing bodies should proactively facilitate workforce awareness and development of assisted dying policy and practice supports in anticipation of legalisation. This can be done through information campaigns and by adapting assisted dying policy, practice materials and systems already developed internationally. Nursing bodies need to engage in formulating legislation to ensure inclusion of explicit protections for participating nurses and to delegate relevant responsibilities to regulatory bodies.
本研究调查了新西兰护士对在各种临床情况下使协助死亡合法化的看法、护士参与合法协助死亡的意愿、参与的潜在障碍和促进因素，以及护士对其专业机构在协助死亡合法化方面的适当角色的看法。
一项使协助死亡合法化的法案目前正在新西兰议会审议。在已经具体立法规定协助死亡的 16 个司法管辖区中，只有加拿大联邦法规为护士执行与协助死亡相关的任务提供了明确的法律保护。在协助死亡合法化之前，缺乏政策制定和规划以确保安全的护理实践，导致专业支持和指导出现空白。
探索性横断面调查。
通过相关医学和护理专业机构的通讯和网站，向 475 名新西兰护士进行了自我选择的在线匿名调查。对支持或对合法化持中立态度的护士进行了亚组抽样（n=356）：对在各种医疗条件下使协助死亡在新西兰合法化的支持程度进行了评分，并对参与一系列协助死亡任务的意愿进行了评分；确定了潜在参与的障碍和促进因素；并评估了专业机构提供实践支持的责任。
采用描述性分析定量数据的混合方法；对定性数据进行主题分析。
护士对合法化的支持率（67%）显著高于医生（37%），支持范围也更为广泛。大多数支持的护士愿意从事所有相关的协助死亡角色。他们确定了一些实际和道德方面的支持是安全参与的必要条件，特别是实践指南、特定培训、法律保护、临床监督和指导以及协助死亡服务提供的独立审查。他们认为这些支持的促进主要是他们专业机构的责任。
护理机构应积极促进对协助死亡政策和实践支持的认识和发展，为合法化做准备。这可以通过宣传活动和改编已经在国际上制定的协助死亡政策、实践材料和系统来实现。护理机构需要参与立法制定，以确保为参与的护士提供明确的保护，并将相关责任委托给监管机构。
