The Impact of Assisted Dying Legislation on Nursing Practice in Palliative Care: A Scoping Review

To review the literature on the state of research on the impacts of assisted dying on nursing practice within specialised palliative care.

A scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews.

PubMed, Embase, CINAHL, PsycINFO and CENTRAL were searched between July and August 2024.

Articles were included if they referred to countries in which assisted dying is legally permitted and is understood as a practice that is not aligned with the philosophy of palliative care, enabling analysis of its impact on nursing practice in specialised palliative care. After the screening process, data were extracted and then synthesised using thematic analysis.

Fifteen studies published between 2019 and 2024, all from Canada or the United States, met the inclusion criteria. Three themes were identified: (1) positioning and meaning, describing how nurses are required to position themselves and to renegotiate their values; (2) impact on core competencies, capturing changes in key nursing responsibilities; and (3) challenges in interpersonal relationships, referring to increased team conflicts and shifts in relationships with patients and their families.

The legalisation of assisted dying impacts nursing practice in palliative care in various ways, challenging the established advanced practice role of specialist palliative care nurses. This calls for comprehensive ethical reflection within the nursing profession regarding its role and core values in this context.

This review identifies significant challenges facing advanced nursing roles and the palliative care discipline. It provides a foundation for future research and ethical deliberation, with relevance for nurses, educators, policymakers and researchers involved in end-of-life care.

This study did not include patient or public involvement in its design, conduct or reporting.