Nurses' and midwives' ethical perspectives on euthanasia legalisation in advanced cancer care

BackgroundEuthanasia remains a highly debated issue in end-of-life care because it raises ethical concerns surrounding patient autonomy, relief of suffering, professional responsibilities, and the sanctity of life. Nurses and midwives frequently face these ethical challenges in caring for patients with advanced illness, yet evidence on their perspectives within sub-Saharan African cancer care settings remains limited.AimThis study explored nurses' and midwives' ethical perspectives and perceived implications regarding the potential legalisation of euthanasia in advanced cancer care in Ghana.Research designThis study employed a descriptive exploratory qualitative design.Participants and research contextTwenty-four nurses and midwives involved in direct cancer care were purposively recruited from six healthcare facilities across Ghana's coastal, forest, and savanna ecological zones. Semi-structured interviews were conducted and analysed using reflexive thematic analysis.Ethical considerationsThe Noguchi Memorial Institute for Medical Research Institutional Review Board approved the study (Approval No: NMIMR-IRB CPN 034/21-22). Participants provided written informed consent, and the researchers ensured confidentiality, anonymity, and voluntary participation throughout the study.FindingsParticipants did not adopt fixed positions regarding euthanasia but actively negotiated competing ethical responsibilities. Participants grounded support for euthanasia in compassion and relief of suffering, while opposition emerged from concerns regarding preservation of life, religious beliefs, professional responsibilities, and possible risks to vulnerable individuals. Participants also situated ethical decision-making within broader family relationships, cultural values, and health system realities.ConclusionsNurses and midwives viewed euthanasia through complex ethical and sociocultural perspectives, highlighting the need for strengthened ethics education, institutional support, and context-sensitive end-of-life care policies.