Treatment refusal: the beliefs and experiences of Alberta nurses

This study explored the beliefs and experiences of Alberta nurses concerning withholding and withdrawal of treatments from incurably or terminally ill patients. A mailed survey containing closed and open-ended questions was used to gather data. A response rate of 47% was achieved. The majority of respondents believed patients should legally be able to request that treatments be withheld (98%) or withdrawn (97%). More than half of the respondents had received requests from patients, families or physicians to withhold or withdraw treatments. Occasionally, nurses acted without physicians' knowledge. Three different positions with respect to decision-making in withholding and withdrawing of care, 'subordinate', 'collaborative' and 'independent', emerged from nurses' written comments on the questionnaire. Consensus among health care practitioners and consumers is critical to end-of-life decision-making.