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Advanced practice registered nurse intended actions toward patient-directed dying
Jessica Jannette1, Marcia Sue DeWolf Bosek, Betty Rambur
1Department of Nursing, The University of Vermont, Burlington, USA.
JONA'S Healthcare Law, Ethics and Regulation
|May 23, 2013
Summary
Advanced practice registered nurses (APRNs) are more willing to discuss patient-directed dying (PDD) than to prescribe medication for it. Their willingness to act increases with stated patient pain and suffering, but education on professional codes is needed.
Area of Science:
- Nursing Practice
- Bioethics
- End-of-Life Care
Background:
- Patient-directed dying (PDD), or physician-assisted suicide, remains a debated topic since Oregon's 1997 Death With Dignity Act.
- Prior research focused on physician, nurse, and patient attitudes toward PDD.
- Limited data exists on advanced practice registered nurses' (APRNs) intended actions regarding PDD.
Purpose of the Study:
- To describe APRNs' intended actions concerning initiating PDD discussions.
- To assess APRNs' willingness to prescribe lethal medication under PDD legislation.
- To explore factors influencing APRN intentions in PDD cases.
Main Methods:
- Pilot study utilizing a survey design.
- Investigator-developed questionnaire distributed electronically.
- Sample of 16 APRNs from a rural northeastern state.
Main Results:
- APRNs showed greater willingness to discuss PDD than to prescribe medication.
- Willingness to initiate discussions and prescribe increased when patient pain and suffering were explicit.
- 75% viewed personal/professional opinions as synonymous, yet 50% were unsure about consistency with the ANA Code of Ethics.
Conclusions:
- APRNs intend to discuss PDD more than actively participate via prescription.
- Patient pain and suffering significantly impact APRN intentions in PDD scenarios.
- Enhanced education on professional codes for APRNs regarding PDD is necessary.
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