Ethical issueIsraeli critical care nurses’ attitudes toward physician-assisted dying
Section snippets
Review of literature
Investigators around the world have researched the attitudes of health care professionals toward hastening the dying process (AE, PAS, and PAD). By far the largest body of literature is related to PAS.
Sample
The study was conducted at a major, nonsectarian, secular, teaching hospital in Israel. The convenience sample consisted of 71 nurses working in four critical care units. A record of the total number of questionnaires distributed was not kept. Therefore, the response rate could not be determined.
Instruments
The questionnaire used in this study was based on the Nurse’s Attitudes Regarding Physician-Assisted Dying Questionnaire,42 which consists of four situational vignettes followed by four possible
Demographic data
The sample consisted of 71 critical care nurses, 7 of whom were males. Approximately half of the sample were native Israelis (n = 35) with the rest immigrating to Israel from Asia (n = 8), Africa (n = 10), Europe (n = 28), the Americas (n = 3), or other countries (n = 1). More than half of the sample had a baccalaureate degree, with 71% having finished a post-basic specialization course in critical care. Most were staff nurses (n = 62). They worked a mean of 12.3 years (standard deviation =
Discussion
Although there is difficulty in comparing results between studies that define end-of-life treatments differently, it is interesting to note that the percentage of agreement of this sample of Israeli critical care nurses with PAD is higher than that of other critical care nurse and most other health care provider samples.8, 13, 14, 25, 33 These results are consistent with previous studies showing that Jewish health care providers tend to have more positive attitudes toward such issues.7, 36
Limitations
The study has several limitations. The sample for this study was a convenience sample, and the number of nurses sampled was small, which possibly affected the results of the study. It should also be noted that the actual refusal rate for participation in the study is unknown. Nurses’ attitudes were determined by the use of vignettes. Some investigators have questioned the use of this technique in that vignettes might not truly reflect the nurses’ attitudes. The questionnaire dealt with
Research
More cross-cultural research needs to be conducted, especially among critical care health care providers, related to the influence of culture and religion on patient care, including that related to PAD. Aspects related to how critical care practice might affect nurses’ attitudes differently than other patient care environments should also be investigated. Comparisons between nurses working in different clinical areas might shed some light on this issue.
Practice
As economic considerations continue to
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