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Nursing Ethics
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Alleviation of Pain and Symptoms With a Life-Shortening Intention

Grada (Ada) G van Bruchem-van de Scheur

Maastricht University, Maastricht, The Netherlands, a.vanbruchem{at}zw.unimaas.nl

Arie JG van der Arend

Maastricht University, Maastricht, The Netherlands

Huda Huijer Abu-Saad

American University of Beirut, Beirut, Lebanon

Frans CB van Wijmen

Maastricht University, Maastricht, The Netherlands

Cor Spreeuwenberg

Maastricht University, Maastricht, The Netherlands

Ruud HJ ter Meulen

University of Bristol, Bristol, UK

This article reports the findings of a study into the role of Dutch nurses in the alleviation of pain and symptoms with a life-shortening intention, conducted as part of a study into the role of nurses in medical end-of-life decisions. A questionnaire survey was carried out using a population of 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The response rate was 82.0%; 78.1% (1179) were suitable for analysis. The results show that in about half of the cases (55.8%) nurses were involved in the decision making by the physician and that nurses were frequently (81.5%) involved in administering the medication. The authors' conclusion is that alleviation of pain and symptoms with a life-shortening intention represents a `grey' area, in which physicians and nurses act on the basis of personal ethical norms rather than legal rules, professional guidelines or shared moral values.

Key Words: alleviation of pain and symptoms • decision making • guidelines • life shortening • nurses • survey

Nursing Ethics, Vol. 15, No. 5, 682-695 (2008)
DOI: 10.1177/0969733008092876
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[Abstract] [PDF]