Potential roles of nurses if Medically Assisted Death (MAD) would be legalised in Finland: a review of nurses’ roles and tasks in MAD care in countries with legal MAD
Elzinga, Jelmer (2022)
Elzinga, Jelmer
2022
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Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:amk-2022121630498
https://urn.fi/URN:NBN:fi:amk-2022121630498
Tiivistelmä
Medically assisted death (MAD) has become a legal part of health care in ten countries the last few years. In those countries patients can receive either euthanasia or medically assisted suicide as a palliative care option when certain conditions are met. Also in Finland, including in parliament, discussions about legalising MAD have been held.
However, international laws rarely specifically mention the role of nurses in the MAD process. Before legalising MAD, the role that nurses may play should be considered.
The aim of this thesis is to investigate what roles and tasks are expected from, and performed by, nurses around a medically assisted death (MAD), in the different countries where this is legal.
A scoping literature review was conducted in which 60 articles containing information on nursing tasks around MAD from six countries were identified. From 34 articles containing primary data on tasks that were actually performed by nurses, all tasks were extracted and classified into nursing roles with a content analysis approach.
Nurses perform roles in all stages of a patient’s MAD process. Most tasks that nurses perform fall within a communication/social role, especially around communicating with and informing the patient and family. They are most often the ones receiving the first MAD request. Nurses also have an important clinical/practical role but involvement in actually carrying out MAD varies between countries. Nurses’ role in deciding whether a patient can receive MAD also varies per country. However, in all countries nurses play a large role in organising the whole MAD process for a patient. Administrative roles are mentioned infrequently. In one country nurses reported that they play an indirect role, developing the MAD nursing field.
In conclusion, nurses play essential roles around the patient’s MAD process. However, differences exist between countries in the tasks that nurses are allowed to perform, due to variation in MAD laws. Law makers need to consider for instance the role nurses are allowed to play in discussing MAD before a request is made, administration of the MAD medicine, and in the decision-making process by the physician.
However, international laws rarely specifically mention the role of nurses in the MAD process. Before legalising MAD, the role that nurses may play should be considered.
The aim of this thesis is to investigate what roles and tasks are expected from, and performed by, nurses around a medically assisted death (MAD), in the different countries where this is legal.
A scoping literature review was conducted in which 60 articles containing information on nursing tasks around MAD from six countries were identified. From 34 articles containing primary data on tasks that were actually performed by nurses, all tasks were extracted and classified into nursing roles with a content analysis approach.
Nurses perform roles in all stages of a patient’s MAD process. Most tasks that nurses perform fall within a communication/social role, especially around communicating with and informing the patient and family. They are most often the ones receiving the first MAD request. Nurses also have an important clinical/practical role but involvement in actually carrying out MAD varies between countries. Nurses’ role in deciding whether a patient can receive MAD also varies per country. However, in all countries nurses play a large role in organising the whole MAD process for a patient. Administrative roles are mentioned infrequently. In one country nurses reported that they play an indirect role, developing the MAD nursing field.
In conclusion, nurses play essential roles around the patient’s MAD process. However, differences exist between countries in the tasks that nurses are allowed to perform, due to variation in MAD laws. Law makers need to consider for instance the role nurses are allowed to play in discussing MAD before a request is made, administration of the MAD medicine, and in the decision-making process by the physician.