Beuthin Rosanne, Bruce Anne, Scaia Margaret
University of Victoria, Victoria, British Columbia, Canada.
Nurs Forum. 2018 Oct;53(4):511-520. doi: 10.1111/nuf.12280. Epub 2018 Jul 4.
Medical assistance in dying (MAiD) represents a historic change in Canadian society and the provision of end-of-life care. In this descriptive narrative inquiry, 17 nurses were interviewed during the first 6 months of assisted dying becoming a legal option for patients in Canada. Nurses' experiences of either providing care for a patient who had chosen MAiD, or declining to participate in MAiD, were explored. Findings describe three themes and eight storylines of the impact of MAiD on nurses' view of the profession, clinical practice, and personally. While most nurses perceived MAiD as an extension of the profession and their nursing practice, a small number also expressed moral distress as they grappled with assisted dying. Narratives illustrated an ongoing sensemaking process and spectrum of emotions. These findings offer insight and provide direction for nurses and managers in this new clinical and legal reality. Further research is needed to understand more fully the moral distress of some nurses, as well as the importance of communicating openly and nonjudgmentally with patients, families, and the health-care team.
医疗协助死亡（MAiD）代表了加拿大社会以及临终关怀领域的一项历史性变革。在这项描述性叙事探究中，在协助死亡成为加拿大患者的合法选择后的头6个月里，对17名护士进行了访谈。探讨了护士为选择医疗协助死亡的患者提供护理或拒绝参与医疗协助死亡的经历。研究结果描述了医疗协助死亡对护士职业观、临床实践及个人影响的三个主题和八个故事情节。虽然大多数护士将医疗协助死亡视为职业及护理实践的延伸，但也有少数护士在应对协助死亡时表达了道德困扰。叙事展示了一个持续的意义建构过程和一系列情感。这些研究结果为处于这一新临床和法律现实中的护士及管理人员提供了见解和指导方向。需要进一步研究以更全面地了解一些护士的道德困扰，以及与患者、家属和医疗团队进行开放且无偏见沟通的重要性。
