AUSTIN, TexasAlthough the nursing profession supports patient
empowerment and self-determination in health care decision-making, patient
requests for assisted dying raise difficult issues. A study reported at the
Oncology Nursing Society’s 26th Annual Conference explored the symptom
management strategies that some nurses use to either counter or preempt
patient requests for help in dying.
Deborah L. Volker, RN, PhD, assistant professor, University of Texas
School of Nursing, Austin, reported results from a secondary analysis of her
larger study of how nurses receive and respond to patient requests for
assistance in dying.
The original study group was derived from a randomized, sequential
mailing of questionnaires to 1,600 ONS members. The questionnaire used a
broad definition of assisted dying, which included not only assisted suicide
and active euthanasia but also nurse-provided advice and teaching related to
Among the 76 oncology nurses who responded to the questionnaire, 40 had
received patient requests for assisted dying. The remaining 36 had not
received such a request but chose to share their experiences with
The study group was representative of the Oncology Nursing Society as a
whole, Dr. Volker said, consisting primarily of white female nurses who were
mostly Christian in their religious orientation. The mean age was 46 (range,
24 to 81), and the mean years of nursing experience was 22, 15 of which were
in oncology nursing.
This secondary analysis focused on the types of symptom management
strategies oncology nurses use in end-of-life care. The final sample for the
secondary analysis was 12 nurses who had denied requests for assisted dying
and had countered with palliative care and 24 nurses who had not received a
request but chose to share their palliative care practices and experiences.
The nurses’ personal stories revealed a variety of symptom management
strategies. Nurses who had received and denied requests for assisted dying
described a variety of physical, emotional, and spiritual strategies. Dr.
Volker read excerpts from some of these nurses’ responses.