1.5.3 Nurses’ attitudes to euthanasia: A Q methodological study (310)

Janet Holt, Senior Lecturer, School of Healthcare Studies, University of Leeds, Leeds, United Kingdom hcsjh@leeds.ac.uk

Abstract:

Background:

Euthanasia is an important issue for nurses in clinical practice as technological advances allow patients to be kept alive using artificial means. Nurses’ attitudes to euthanasia are of particular importance individually, because of their close involvement and experience in the care of the dying patient, and collectively, because of their influence upon healthcare policy and practice. Q methodology enables data to be collected and systematically analysed through factor analysis but also allows an element of subjectivity, as the focus in Q methodology is the participant’s subjective response to the statements and the exploration of differing accounts constructed by them (McKeown & Thomas, 1988).

Aims:

To explore diversity in nurses’ subjective understanding of voluntary active euthanasia
To investigate similarities and differences in these understandings in nurses with different clinical experiences

Method:

Using a Q sort technique, sixty nurses working in ICUs, hospices and nursing homes (in 2006) sorted a Q set consisting of 50 items derived from data collected in focus groups. Biographical information was collected and participants were given a booklet to record any comments they had about the statements. The qualitative comments were used to add depth of understanding in data interpretation.

Results:

Analysis with Principal Component Method and Varimax rotation revealed three different understandings of nurses’ attitudes to euthanasia representing differing beliefs. These were;

Cautiously supportive of euthanasia
Against euthanasia
Supportive of patient autonomy

The beliefs differed in their agreement and disagreement with the issues associated with euthanasia (the items in the Q set), and in their focus on the nurse or patient experience.

Discussion:

How the three understandings of euthanasia differed with reference to the participants’ clinical speciality, experience, and religious beliefs
The advantages of Q methodology for empirical investigation of ethical questions

Biography:

Janet Holt is a Senior Lecturer in healthcare ethics and law in the School of Healthcare at the University of Leeds, and the Learning and Teaching Consultant for Ethics in the Health Sciences & Practice at the Higher Education Academy in the UK. She is a registered nurse and midwife with a BA in Philosophy from the University of Leeds, an MPhil in Applied Philosophy from the University of Manchester and a PhD in Psychology from the University of Leeds. Janet’s research interests and publications are within the disciplines of healthcare ethics and law, and nursing philosophy. She is particularly interested in the learning and teaching of ethics in the education of healthcare practitioners and has recently completed an exploration of learning and teaching ethics in the UK nursing curriculum. Janet’s PhD consisted of four studies in a mixed methodological approach systematically investigating UK nurses' attitudes to euthanasia. A member of the Editorial Board of the journal Nursing Philosophy, Janet was elected Chair of the International Philosophy of Nursing Society in September 2007. She also is an expert member of a local NHS Research Ethics Committee and an independent member of the Standards Committee of North Yorkshire County Council.