To Explore the Nurses’ Roles in Discouraging Palliative Patients from Euthanasia
Jose Cardentey Hernandez
Nursing Research and Evidence-Based-DL-MSN1
Sep 26, 2021
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To Explore the Nurses’ Roles in Discouraging Palliative Patients from Euthanasia
Introduction to the Problem
The issue of dying with dignity and the right to die has been debated for decades. The
debate revolves around whether a person should be allowed to choose to die when they can
continue living at a diminished capacity or aid of life support. The debate is centered on the ethical
position of the medical intervention. One of the questions is whether the right to die is universal
and only applicable in palliative care. On an ethical basis, health professionals should adhere to
patient autonomy which questions euthanasia as a care intervention. Nurses in assisted death face
conflicting requirements from autonomy, maleficence, and non-maleficence. However, the concept
of freedom of expression exists where the dying patient has a right to make decisions regarding
Nurses play a vital role in caring for patients during their end of life compared to other
health care professionals (Dierckx de Castle, 2006). Technological advancement in healthcare has
facilitated quality of life and prolonged life. However, technological advancement has also led to
controversial debates on euthanasia (Berghs et al., 2005). According to Asai et al. (2019), the
attitudes towards the legality and the ethics of euthanasia has drastically changed in the last few
decades. This has led to the legalization of euthanasia in some countries, but the circumstances of
assisted suicide vary from one city to another.
The issue of cancer is a global issue, and it has increased the need for palliative care
services. Nurses provide care geared towards patient satisfaction. In palliative care, the nurses
work towards meeting cancer patients’ needs during the end of life care (Henson et al., 2016).
During the end of life, the patients and the family face challenges and must make choices that
benefit the patient. Wright et al. (2016) explain that choices during the end of life may have a
ATTITUDES OF NURSES IN EUTHANASIA 3
quality of life dimension where the nurse guides the patient and the carer to adapt to painful
realities and confront difficult situations.
The practice of euthanasia involves medical procedures that end life to relieve the patients
suffering or pain. The concept of euthanasia is explained by the American Medical Association’s
Code of Medical Ethics (1997) as a process where a health professional facilitates a patient’s death
by providing the necessary means and information to enable the patient to perform the life-ending
act” (p. 56).
According to Gill (2019), there are different forms of euthanasia; passive, active, voluntary
and non-voluntary. On voluntary euthanasia, the patients request health professionals to die, while
non-voluntary involves death assistance in patients who cannot make requests like infants and
comatose patients. On active and passive euthanasia, passive procedures withhold life-sustaining
treatments while active is injected with lethal drugs. According to Gill (2019), the goal of
euthanasia is to relieve patients from unbearable pain and allow them to die with dignity. Although
cancer is a significant cause of palliative care, a rising number of patients like children and
neonates require palliative care. Some of the conditions resulting in palliative care include frailty,
dementia, learning disabilities, and seniors with multiple comorbidities.
Significance of the problem to Nursing
Although nurses spend more time with palliative patients and receive euthanasia requests,
their views on the procedure remain unclear. This creates a research gap and a need to conduct an
in-depth exploration of nurses’ attitudes and involvement in euthanasia decision making. The
responsibility of nurses in palliative care is to provide compassionate and comprehensive end of
ATTITUDES OF NURSES IN EUTHANASIA 4
life care. According to Weaver et al. (2018), the cost of caring for the palliative patient has a
financial impact and physical, emotional and psychological.
The caring process may negatively affect caregivers resulting in physical illness,
psychiatric illness, physiologic responses, impaired health habits, psychological distress or death.
Several factors influence the attitudes of nurses towards palliative care. For example, religion
views euthanasia as a practice that is against the value of human life. Such nurses may view the
practice as an unethical sanctioned choice hence discouraging euthanasia. Due to the varying
factors influencing the decision making of euthanasia in palliative care, there is a need to explore
the attitude of palliative nurses towards euthanasia.
Purpose of the Research
The purpose of the study is to describe and explore the attitude of palliative nurses towards
The primary research topic is; what is the attitude of nurses regarding voluntary euthanasia, and
should they encourage or discourage the process? The following specific research questions will
What is palliative nurses’ attitude towards voluntary euthanasia?
What are the ways in which palliative nurses wish to get involved involuntary euthanasia?
What is the relationship between the demographic characteristics of palliative nurses and
their attitude towards voluntary euthanasia?
Master’s Essentials that aligned with your topic
The concept of euthanasia is in line to the World Health Organization definition of palliative care.
According to WHO, palliative care is,
ATTITUDES OF NURSES IN EUTHANASIA 5
“… an approach that improves the quality of life of patients and their families facing the problem
associated with life-threatening illness, through the prevention and relief of suffering by means of
early identification and impeccable assessment and treatment of pain and other problems,
physical, psychosocial and spiritual” (National Consensus Project for Quality Palliative Care,
2009, p. 8). Palliative care “affirms life and regards dying as a normal process” and “intends
neither to hasten nor postpone death” (Ferrell et al., 2018, p. 8).
Although euthanasia involves the prevention of suffering and relieving patients’ pain, it is
against the goal of nursing care, which is to promote quality of life. However, it is in line with
palliative care on providing care and support to help patients die with dignity (Cardiff University,
2014). Different professional organizations in nursing address the issue of euthanasia and the
clinical participation of health professionals. According to Cardiff University (2014), assisted
suicide is contrary to professional role integrity as it violates the social construct of health
professionals to the people. Besides, the procedure is contrary to the role of nurses and other health
professionals in promoting healing, creating a social risk.
A master’s in palliative care is to promote patient outcomes through quality palliative care
facilitated by quality improvement and research. The role of the course is patient care improvement
through the delivery of effective and accessible education. The goal is to help nurses to develop,
extend and share their understanding, knowledge and application of evidence to palliative care.
Other essentials include research evidence, challenges, frameworks, and core understanding that
develop and optimize palliative care and palliative medicine practice. It also assists students in
identifying significant issues in their practice and conducting evidence-based research (Cardiff
University, 2014). The goal is to attain vital information to the practice and knowledge of palliative
care and palliative medicine.
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ATTITUDES OF NURSES IN EUTHANASIA 7
American Medical Association. (1997). American Medical Association. Code of Medical Ethics.
Asai, A., Ohnishi, M., Nagata, S. K., Tanida, N., & Yamazaki, Y. (2019). Doctors’ and nurses’
attitudes towards and experiences of voluntary euthanasia: survey of members of the
Japanese Association of Palliative Medicine. Journal of medical ethics, 27(5), 324-330.
Berghs, M., De Casterle, B. D., & Gastmans, C. (2005). The complexity of nurses’ attitudes toward
euthanasia: a review of the literature. Journal of Medical Ethics, 31(8), 441-446.
Cardiff University. (2014). Palliative Medicine for Health Care Professionals
medicine-for-health-care-professionals-msc-part-time. Cardiff University. Retrieved 26
September 2021, from
Dierckx de Casterle, B. (2006). Nurses’ views on their involvement in euthanasia: a qualitative
study in Flanders (Belgium). Journal Of Medical Ethics, 32(4), 187-192.
Ferrell, B. R., Twaddle, M. L., Melnick, A., & Meier, D. E. (2018). National consensus project
clinical practice guidelines for quality palliative care guidelines. Journal of palliative
medicine, 21(12), 1684-1689.
Gill, B. (2019). Euthanasia and Nurses Role in It. IRIS.
ATTITUDES OF NURSES IN EUTHANASIA 8
Henson, L. A., Gomes, B., Koffman, J., Daveson, B. A., Higginson, I. J., & Gao, W. (2016).
Factors associated with aggressive end of life cancer care. Supportive Care in
Cancer, 24(3), 1079-1089.
Weaver, M. S., Wichman, B., Bace, S., Schroeder, D., Vail, C., Wichman, C., & Macfadyen, A.
(2018). Measuring the impact of the home health nursing shortage on family caregivers of
children receiving palliative care. Journal of Hospice and Palliative Nursing, 20(3), 260.
Wright, A. A., Keating, N. L., Ayanian, J. Z., Chrischilles, E. A., Kahn, K. L., Ritchie, C. S., … &
Landrum, M. B. (2016). Family perspectives on aggressive cancer care near the end of
life. Jama, 315(3), 284-292.
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