The Dutch have a law which regulates voluntary euthanasia, but studies regularly show that many doctors fail to observe it. Now new government-funded research has shown that cocking a snook at the law is not a prerogative of doctors. Nurses participate in 1 out of 8 cases of Dutch euthanasia -- which is definitely illegal. The latest Journal of Medical Ethics sketches what nurses do and how often they participate in hospitals, nursing homes and home care, based on a survey of more than a thousand nurses. Other studies suggest that nurses might be taking an even more active role. A couple claim that they collaborate with doctors in 59% of euthanasia cases in hospitals, and administer it by themselves in 21%.

Why do nurses get involved, if the law clearly excludes them? It appears that some doctors are insufficiently experienced in administering lethal drugs, so nurses step in. As the article says, “as the moment of infusion is important to the patient and/or relatives, nurses may feel compelled at that very moment to take over the procedure”.

According to the survey, Dutch nurses have few reservations about euthanasia. When a doctor decided to grant a patient’s request to die, they supported him nearly 90% of the time. When they declined -- which happened in only about 1 in 5 cases, 37% of the nurses disagreed with the decision or had doubts about it.

In hospitals and nursing homes, nurses play an important role in helping patients to decide whether to go ahead with a request for euthanasia. Twice as often as doctors, the patients raise the issue with them first. Why? There were a number of reasons, but what tips the scales is that nurses have a more personal relationship with patients than doctors. ~ Journal of Medical Ethics, April