Asch D A
Philadelphia Veterans Affairs Medical Center, PA, USA.
N Engl J Med. 1996 May 23;334(21):1374-9. doi: 10.1056/NEJM199605233342106.
Euthanasia and assisted suicide has received considerable attention recently in medical literature, public discussion, and proposed state legislation. Almost all the discussion in this area has focused on the role of physicians. However, nurses--especially critical care nurses--may be in a special position to understand the wishes of patients and to act on this understanding.
I mailed a survey to 1600 critical care nurses in the United States, asking them to describe anonymously any requests from patients, family members or others acting for patients (surrogates), or physicians to perform euthanasia or assisted suicide, as well as their own practices.
Of the 1139 nurses who responded (71 percent), 852 said they practices exclusively in intensive care units for adults in the United States. Of these 852 nurses, 141 (17 percent) reported that they had received requests from patients or family members to perform euthanasia or assist in suicide; 129 (16 percent of those for whom data were available) reported that they had engaged in euthanasia; and an additional 36 (4 percent) reported that they had hastened a patient's death by only pretending to provide life-sustaining treatment ordered by a physician. Some nurses reported engaging in these practices without the request for advance knowledge of physicians or others. The method of euthanasia most commonly described was the administration of a high dose of an opiate to a terminally ill patient.
As public debate continues about euthanasia and assisted suicide, some critical care nurses in the United States are engaging in the practice.
安乐死和协助自杀最近在医学文献、公众讨论以及拟议的州立法中受到了相当多的关注。该领域几乎所有的讨论都集中在医生的角色上。然而，护士——尤其是重症监护护士——可能处于一个特殊的位置，能够理解患者的意愿并据此采取行动。
我向美国1600名重症监护护士邮寄了一份调查问卷，要求他们匿名描述患者、家庭成员或其他代表患者行事的人（代理人）或医生提出的任何实施安乐死或协助自杀的请求，以及他们自己的做法。
在1139名回复的护士中（71%），852人表示他们专门在美国的成人重症监护病房工作。在这852名护士中，141人（17%）报告称他们收到过患者或家庭成员提出的实施安乐死或协助自杀的请求；129人（有数据可查者中的16%）报告称他们实施过安乐死；另有36人（4%）报告称他们只是假装按照医生的医嘱提供维持生命的治疗，从而加速了患者的死亡。一些护士报告称在没有得到医生或其他人事先知晓的情况下就实施了这些行为。最常描述的安乐死方法是给绝症患者注射高剂量的鸦片剂。
随着关于安乐死和协助自杀的公开辩论的继续，美国一些重症监护护士正在实施这种做法。
