Motivations of Physicians and Nurses to Practice Voluntary Euthanasia: a Systematic Review

Overview

Journal BMC Palliat Care

Publisher Biomed Central

Specialty Critical Care

Date 2014 Apr 11

PMID 24716567

Citations 5

Authors

Lydi-Anne Vezina-Im

Mireille Lavoie

Pawel Krol

Marianne Olivier-dAvignon

Affiliations

Soon will be listed here.

Abstract

Background: While a number of reviews have explored the attitude of health professionals toward euthanasia, none of them documented their motivations to practice euthanasia. The objective of the present systematic review was to identify physicians' and nurses' motives for having the intention or for performing an act of voluntary euthanasia and compare findings from countries where the practice is legalized to those where it is not.

Methods: The following databases were investigated: MEDLINE/PubMed (1950+), PsycINFO (1806+), CINAHL (1982+), EMBASE (1974+) and FRANCIS (1984+). Proquest Dissertations and Theses (1861+) was also investigated for gray literature. Additional studies were included by checking the references of the articles included in the systematic review as well as by looking at our personal collection of articles on euthanasia.

Results: This paper reviews a total of 27 empirical quantitative studies out of the 1 703 articles identified at the beginning. Five studies were in countries where euthanasia is legal and 22 in countries where it is not. Seventeen studies were targeting physicians, 9 targeted nurses and 1 both health professionals. Six studies identified the motivations underlying the intention to practice euthanasia, 16 the behavior itself and 5 both intention and behavior. The category of variables most consistently associated with euthanasia is psychological variables. All categories collapsed, the four variables most frequently associated with euthanasia are past behavior, medical specialty, whether the patient is depressed and the patient's life expectancy.

Conclusions: The present review suggests that physicians and nurses are motivated to practice voluntary euthanasia especially when they are familiar with the act of euthanasia, when the patient does not have depressive symptoms and has a short life expectancy and their motivation varies according to their medical specialty. Additional studies among nurses and in countries where euthanasia is legal are needed.

Citing Articles

Attitudes of university hospital staff towards in-house assisted suicide.

Gamondi C, Gayet-Ageron A, Borasio G, Hurst S, Jox R, Ricou B PLoS One. 2022; 17(10):e0274597.

PMID: 36301971 PMC: 9612505. DOI: 10.1371/journal.pone.0274597.

Attitudes on euthanasia among medical students and doctors in Sri Lanka: a cross sectional study.

Herath H, Wijayawardhana K, Wickramarachchi U, Rodrigo C BMC Med Ethics. 2021; 22(1):162.

PMID: 34876119 PMC: 8650524. DOI: 10.1186/s12910-021-00731-2.

The Relationship of Palliative Care With Assisted Dying Where Assisted Dying is Lawful: A Systematic Scoping Review of the Literature.

Gerson S, Koksvik G, Richards N, Materstvedt L, Clark D J Pain Symptom Manage. 2019; 59(6):1287-1303.e1.

PMID: 31881289 PMC: 8311295. DOI: 10.1016/j.jpainsymman.2019.12.361.

Information needs of francophone health care professionals and the public with regard to medical assistance in dying in Quebec: a qualitative study.

Boivin A, Gauvin F, Garnon G, Gancia A, Rouly G, Marcoux I CMAJ Open. 2019; 7(2):E190-E196.

PMID: 30948647 PMC: 6450793. DOI: 10.9778/cmajo.20180155.

Palliative care professionals' willingness to perform euthanasia or physician assisted suicide.

Zenz J, Tryba M, Zenz M BMC Palliat Care. 2015; 14:60.

PMID: 26572742 PMC: 4647811. DOI: 10.1186/s12904-015-0058-3.

References

Rosenfeld B . Methodological issues in assisted suicide and euthanasia research. Psychol Public Policy Law. 2003; 6(2):559-74. View

Gielen J, Van den Branden S, Broeckaert B . The operationalisation of religion and world view in surveys of nurses' attitudes toward euthanasia and assisted suicide. Med Health Care Philos. 2009; 12(4):423-31. DOI: 10.1007/s11019-009-9217-8. View

Back A, Wallace J, Starks H, Pearlman R . Physician-assisted suicide and euthanasia in Washington State. Patient requests and physician responses. JAMA. 1996; 275(12):919-25. View

Michie S, Fixsen D, Grimshaw J, Eccles M . Specifying and reporting complex behaviour change interventions: the need for a scientific method. Implement Sci. 2009; 4:40. PMC: 2717906. DOI: 10.1186/1748-5908-4-40. View

Quaghebeur T, de Casterle B, Gastmans C . Nursing and euthanasia: a review of argument-based ethics literature. Nurs Ethics. 2009; 16(4):466-86. DOI: 10.1177/0969733009104610. View

Onwuteaka-Philipsen B, Brinkman-Stoppelenburg A, Penning C, de Jong-Krul G, van Delden J, van der Heide A . Trends in end-of-life practices before and after the enactment of the euthanasia law in the Netherlands from 1990 to 2010: a repeated cross-sectional survey. Lancet. 2012; 380(9845):908-15. DOI: 10.1016/S0140-6736(12)61034-4. View

Davis A, Davidson B, Hirschfield M, Lauri S, Lin J, Norberg A . An international perspective of active euthanasia: attitudes of nurses in seven countries. Int J Nurs Stud. 1993; 30(4):301-10. DOI: 10.1016/0020-7489(93)90102-z. View

Parker M, Cartwright C, Williams G . Impact of specialty on attitudes of Australian medical practitioners to end-of-life decisions. Med J Aust. 2008; 188(8):450-6. DOI: 10.5694/j.1326-5377.2008.tb01714.x. View

Stevens C, Hassan R . Nurses and the management of death, dying and euthanasia. Med Law. 1994; 13(5-6):541-54. View

10.

Richardson D . Oncology nurses' attitudes toward the legalization of voluntary active euthanasia. Cancer Nurs. 1994; 17(4):348-54. View

11.

Berghs M, Dierckx de Casterle B, Gastmans C . The complexity of nurses' attitudes toward euthanasia: a review of the literature. J Med Ethics. 2005; 31(8):441-6. PMC: 1734202. DOI: 10.1136/jme.2004.009092. View

12.

Stevens C, Hassan R . Management of death, dying and euthanasia: attitudes and practices of medical practitioners in South Australia. J Med Ethics. 1994; 20(1):41-6. PMC: 1376373. DOI: 10.1136/jme.20.1.41. View

13.

Maitra R, Harfst A, Bjerre L, Kochen M, Becker A . Do German general practitioners support euthanasia? Results of a nation-wide questionnaire survey. Eur J Gen Pract. 2006; 11(3-4):94-100. DOI: 10.3109/13814780509178247. View

14.

Inghelbrecht E, Bilsen J, Mortier F, Deliens L . Attitudes of nurses towards euthanasia and towards their role in euthanasia: a nationwide study in Flanders, Belgium. Int J Nurs Stud. 2009; 46(9):1209-18. DOI: 10.1016/j.ijnurstu.2009.02.009. View

15.

Sierles F . How to do research with self-administered surveys. Acad Psychiatry. 2003; 27(2):104-13. DOI: 10.1176/appi.ap.27.2.104. View

16.

Guillaumie L, Godin G, Vezina-Im L . Psychosocial determinants of fruit and vegetable intake in adult population: a systematic review. Int J Behav Nutr Phys Act. 2010; 7:12. PMC: 2831029. DOI: 10.1186/1479-5868-7-12. View

17.

Kunene S, Zungu B . An investigation into the attitude of professional nurses towards euthanasia. Curationis. 1996; 19(4):26-30. DOI: 10.4102/curationis.v19i4.1332. View

18.

Obstein K, Kimsma G, Chambers T . Practicing euthanasia: the perspective of physicians. J Clin Ethics. 2005; 15(3):223-31. View

19.

TRIANDIS H . Values, attitudes, and interpersonal behavior. Nebr Symp Motiv. 1980; 27:195-259. View

20.

Gielen J, Van den Branden S, Broeckaert B . Attitudes of European physicians toward euthanasia and physician-assisted suicide: a review of the recent literature. J Palliat Care. 2008; 24(3):173-84. View