Nursing care for patients requesting euthanasia in general hospitals in Flanders, Belgium

This paper is a report of a study exploring nurses' involvement in the care process for mentally competent, terminally ill patients requesting euthanasia in general hospitals in Flanders, Belgium.

International literature shows that nurses are involved in the care process surrounding euthanasia, regardless of the legal status of euthanasia in the country being studied. However, their actual involvement remains unclear.

A grounded theory approach was used. Data were collected over a 20-month period in 2005 and 2006, using individual in-depth interviews. The sample included 18 Registered Nurses employed in nine general hospitals geographically spread over the five provinces of Flanders, Belgium.

The care process for patients requesting euthanasia is complex and dynamic, consisting of several stages. Major themes characterized nurses' involvement: being on the alert for a euthanasia request; open and active listening; multidisciplinary team cooperation and analysis of the group dynamics; continuously providing maximum palliative care; multi-tasking; organizing and directing the euthanasia; and finally, providing support for the family, colleagues and oneself.

Nurses make a unique and indispensable contribution to making the euthanasia care process a good care process. This has to do with their specific form of knowledge, expertise and responsibilities, and their willingness to personally, continually and fully care for the patients requesting euthanasia and for their relatives.