Oncology nurses' practices of assisted suicide and patient-requested euthanasia.

PURPOSE/OBJECTIVES: To provide reliable and valid empirical data related to New England Oncology Nursing Society (ONS) members' self-reported practices of assisted suicide and patient-requested euthanasia. Analysis focused on the nurses' practices, a comparison of their practices to a similar sample of oncology physicians, and their use of the healthcare team.

DESIGN

Quantitative survey.

SETTING

New England region of the United States.

SAMPLE

600 ONS members surveyed by mail, 441 of whom responded (74% return rate). Only nurses who worked at least 20 hours per week, were ONS members for at least one year, and worked with adult patients with cancer were included.

METHODS

Replication and extension of a survey of oncology physicians.

MAIN RESEARCH VARIABLES

Frequency of requests for and responses to patient requests for assisted suicide and euthanasia and the use of the healthcare team in response to these requests.

FINDINGS

More physicians than nurses assisted their patients' suicides (11% versus 1%). However, nurses were more likely than physicians to have performed patient-requested euthanasia (4% versus 1%). Nurses frequently consulted with others--particularly physicians--about patient requests for assistance with death but rarely with one another including nursing supervisors.

CONCLUSIONS

The relative number of healthcare professionals (physicians or nurses) who admit to hastening a patient's death is small. Nurses in this study received fewer requests to perform euthanasia than physicians, but they performed patient-requested euthanasia four times more frequently than physicians. Professional affiliation appears to be one factor in determining whether or not a patient's request for assistance with death will be granted. IMPLICATIONS FOR NURSING PRACTICES: The policy debate about professional roles in actions that end the lives of patients must be extended beyond physicians to include nurses. Nurses must take an active role in the discussion and definition of acceptable practice at the end of life.