Nursing care in assisted dying: Plasticity and relational commitment

Background
Spain’s Euthanasia Law came into force in 2021. Nurses are involved throughout the entire process and yet the law only recognizes their role in the final administration of the drug.
Objective
To understand the practice and experience of nurses involved in the euthanasia process.
Research design
Qualitative study with a phenomenological approach. An interpretative phenomenological analysis was conducted using ATLAS-ti.
Participants and research context
This study is part of a larger project for which the study population comprised professionals who have participated in the euthanasia process in Catalonia since the law came into force. This study is based on data collected from nurses through 6 in-depth interviews and 3 focus groups.
Ethical considerations
This study was approved by the Ethics Committee (22/094-P). All participants granted their informed consent. Interviews and focus groups were anonymized.
Findings
The results revolve around two themes: (1) Plasticity of nursing care in the face of regulatory gaps and (2) managing emotions while providing assisted dying. Nurses respond to patients and families by adapting to the demands of the process and self-managing any emotions that arise from participating in this practice. Nurses use rationalization to manage the range of emotions they experience resulting from the tension between respecting a person’s autonomous decision to request euthanasia and upholding their professional duty to prevent harm. The team stands out as a crucial element in managing these emotions.
Conclusions
Spanish nurses are involved throughout the entire euthanasia process, demonstrating great plasticity of care. Euthanasia care is complex and the relational context between professionals and the patient/family and between team members is key. The law should define and envisage the role of nurses, as it does for other professions.