Regulation and legislation of the dying process: views of health care professionals

Because of radical changes that have been effected by medical advances in the process of dying, it is now frequently necessary for patients to make an explicit decision on whether to forego life-prolonging medical therapies. We report physicians' and nurses' perceptions of the need for, feasibility of, and value of regulations and legislation to govern the dying process. In-depth, semistructured interviews were conducted with a sample of 20 physicians and 20 nurses at a large teaching hospital. There was little unanimity in their attitudes toward whether it is advisable or feasible to devise adequate legal safeguards for physicians and nurses who assist patients to hasten their deaths. Some believed such regulations were needed, but others believed they would seriously compromise good patient care. There was also disagreement as to who should develop guidelines. There was, however, clear opposition among most participants to the involvement of lawyers in the process of clarifying the content of regulations and legislation on the dying process.