Impact of Written Ethics Policy on Euthanasia From the Perspective of Physicians and Nurses: A Multiple Case Study in Hospitals.

Euthanasia decision making is a complex process for physicians and nurses that involves clinical, legal, ethical, and personal-emotional aspects. In this respect, attention has been given to hospitals' written ethics policies on euthanasia. The aim of our study was to explore the impact of a written ethics policy on euthanasia, as experienced by physicians and nurses involved in euthanasia care processes. A qualitative multiple case study in three selected general hospitals was conducted. Grounded theory methodology was used to guide data collection and analysis. The purposive sample resulted in 23 in-depth interviews with physicians (n = 11) and nurses (n = 12). The euthanasia policy gave the care providers a sense of being supported throughout the euthanasia care process. While care providers mainly feel the influence of a euthanasia policy on practical and professional levels of providing care, the influence of a policy on the providers' ethical reflection and practice is less clear. The study raises questions about the meaning of a written ethics policy for the ethical practice of physicians and nurses, when they have to deal with ethically sensitive issues such as euthanasia. [ABSTRACT FROM AUTHOR]