Nurses' values on medical aid in dying: A qualitative analysis

Area of Science:

• Nursing
• Bioethics
• Medical Law

Background:

• Medical aid in dying (MAID) is increasingly legalized in the US.
• Current laws and professional guidelines restrict nursing involvement in MAID.
• Nurses' personal values and perceptions regarding MAID are not well understood.

Purpose of the Study:

• To explore the values and perceptions of nurses concerning medical aid in dying.
• To understand the spectrum of nurse opinions on their role in MAID.
• To identify areas for improved education and policy development for nurses in MAID.

Main Methods:

• A cross-sectional electronic survey was distributed to members of the American Nurses Association.
• Inductive thematic content analysis was used for 3639 open-ended comments from 1213 nurses.
• Participant demographics included over 80% self-identified as white, 58% held graduate degrees, and half were of Christian faith.

Main Results:

• Nurse values on MAID exist on a continuum, categorized into four themes: 'Honoring Patient Autonomy without Judgment,' 'Honoring with Limitations,' 'Not until...,' and 'Adamantly against.'
• Some nurses viewed honoring patient wishes as a duty, often with spiritual considerations, while others expressed concerns about the process, policy, psychological harm, and legal risks.
• Opposition to MAID was linked to beliefs about murder/suicide and religious objections; differing views emerged on allowing patient support with medications and MAID via advance directives.

Conclusions:

• Nurses require further education on their roles and the practice of MAID.
• There is no single, universally accepted stance among nurses regarding MAID.
• Healthcare policies and standards must adapt to the wide range of nurses' values and experiences with MAID.