INTRODUCTION: Euthanasia because of unbearable mental suffering (UMS euthanasia) has been legal in Belgium since 2002, under certain circumstances that govern careful practice. Despite the legal framework, there are specific difficulties and concerns regarding UMS euthanasia. Mental health nurses are often involved in the process, but little is known about their attitudes towards UMS euthanasia, their role and their knowledge.

AIM: To determine the attitudes, role and knowledge of mental health nurses regarding UMS euthanasia.

METHODS: A cross-sectional survey was performed at a convenience sample of four psychiatric hospitals in Belgium (n=133) as a pilot study. Self-administered questionnaires were provided to mental health nurses.

RESULTS: Half the nurses in our sample had been involved at least once in the process of UMS euthanasia. A large majority of mental health nurses were supportive of UMS euthanasia. Nurses show differences in attitudes related to the different psychiatric pathologies of the patients, and in whether or not minors are involved. In some cases, they believed that the mental suffering of psychiatric patients can be unbearable and irreversible and that psychiatric patients can be competent to voluntarily request UMS euthanasia. Nurses stated that they have an important role in the UMS euthanasia process, but also demanded more knowledge and clear guidelines to implement the procedure.

DISCUSSION: Nurses have a key role regarding UMS euthanasia but face several challenges: the recent process, resistance to a multidisciplinary approach by psychiatrists and an unclear role defined by the legal framework. Nurses do not appear to have a common voice on the topic and the development of clear guidelines appears to be essential. Social recovery can offer a way out of an UMS euthanasia request, but it will not always offer a solution.

IMPLICATIONS FOR PRACTICE: Sufficient attention must be paid to how mental health nurses can be involved in the process of UMS euthanasia at various levels: bedside practice, healthcare management, education and policy. A form of systematic cooperation between nurses, physicians and patients can contribute to the utmost careful decision-making process needed in these cases. There is a need for proper training in: knowledge of psychiatric pathologies and remaining treatment options; communication skills; the legal framework and all its difficulties; transdisciplinary and multicultural approaches; ethical reflection and how nurses handle their own emotions. This article is protected by copyright. All rights reserved.

Original languageEnglish
Pages (from-to)400-410
Number of pages11
JournalJournal of Psychiatric and Mental Health Nursing
Issue number7
Publication statusPublished - Sep 2018

    Research areas

  • euthanasia, mental health nursing, psychiatric nursing, psychiatry, unbearable mental suffering, Attitude of Health Personnel, Psychiatric Nursing/statistics & numerical data, Humans, Middle Aged, Male, Health Knowledge, Attitudes, Practice, Young Adult, Pilot Projects, Belgium, Adult, Female, Euthanasia, Nursing Staff, Hospital/statistics & numerical data

ID: 38077552