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Euthanasia and physician-assisted suicide in the Dutch homecare sector: the role of the district nurse

Authors

  • G.G. Van Bruchem-van de Scheur,

    1. G.G. van Bruchem-van de Scheur MSc PhD StudentDepartment of Health Ethics and Philosophy, Maastricht University, Maastricht, The Netherlands
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  • Arie J.G. Van Der Arend,

    1. Arie J.G. van der Arend PhD Associate Professor Department of Health Ethics and Philosophy, Maastricht University, Maastricht, The Netherlands
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  • Cor Spreeuwenberg,

    1. Cor Spreeuwenberg MD Professor Department of Health Care Studies, Maastricht University, Maastricht, The Netherlands
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  • Huda Huijer Abu-Saad,

    1. Huda Huijer Abu-Saad PhD RN FEANS Professor School of Nursing, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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  • Ruud H.J. Ter Meulen

    1. Ruud H.J. ter Meulen PhD Professor Centre for Ethics in Medicine, University of Bristol, Bristol, UK
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G.G. van Bruchem-van de Scheur:
e-mail: a.vanbruchem@zw.unimaas.nl

Abstract

Title. Euthanasia and physician-assisted suicide in the Dutch homecare sector: the role of the district nurse

Aim.  This paper is a report of the findings of a study into the role of district nurses in euthanasia and physician-assisted suicide in homecare organizations, conducted as part of a study into the role of nurses in medical end-of-life decisions.

Background.  Issues concerning legislation and regulation with respect to the role of nurses in euthanasia and physician-assisted suicide gave the Minister for Health reason to commission a study into the role of nurses in medical end-of-life decisions in hospitals, nursing homes and homecare organizations. This is the first quantitative study from the perspective of nurses. Previous quantitative studies were conducted under physicians and information on the role of nurses was obtained indirectly.

Method.  A questionnaire was sent in 2003 to 500 district nurses employed in 55 homecare organizations. The absolute response rate was 86·0% and 81·6% (408) could be used for analysis.

Results.  In 22·3% of 278 cases, the district nurse was the first with whom patients discussed their request for euthanasia or physician-assisted suicide. In about half (49·8%) of 267 cases nurses were not involved in the general practitioner's decision-making process, and in only 13·3% of 264 cases, did they attend the administration of the lethal drugs. District nurses had provided some degree of aftercare to the surviving relatives in 80·3% of 264 cases.

Conclusion.  Collaboration between general practitioners and district nurses needs improvement, particularly in relation to decision-making. Our Dutch data could help nurses in other countries to define their (future) role in euthanasia and physician-assisted suicide.

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