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 assisted dying.
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 end-of-life care.
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.