EUTHANASIA AND NURSING: CHALLENGES IN PROFESIONAL TRAINING AND IN THE PRACTICE OF END-OF-LIFE CARE
DOI:
https://doi.org/10.22370/bre.101.2025.4809.Keywords:
Euthanasia, Nursing Care, Nursing Ethics, Advance Care Planning, SimulationAbstract
Introduction: Euthanasia constitutes a profound ethical and professional challenge for healthcare providers, particularly within the nursing discipline, where training on end-of-life care remains limited. Objective: To identify essential knowledge areas—specifically related to euthanasia and end-of-life care—that should be incorporated into nursing education to foster ethical and empathetic practice. Reflection: This reflective analysis examines euthanasia as an ethical dilemma in nursing practice, considering multiple dimensions: ethical and technological training in this domain, the tensions between euthanasia and palliative care, comprehensive comfort, and dignified accompaniment of suffering as a professional obligation. The discussion underscores the need for holistic education that integrates palliative care and clinical simulation as strategies to enhance the preparedness of future practitioners. Conclusion: From a nursing perspective, it is imperative to address euthanasia and end-of-life care explicitly. In this context, ethical education and the development of specialized competencies emerge as foundational pillars for preparing professionals capable of confronting the complexities associated with euthanasia and palliative care. This preparation requires the integration of theoretical frameworks, innovative pedagogical approaches, and technological resources that promote critical reflection and clinical proficiency in both real and simulated environments
Downloads
References
Bellon F, Mateos JT, Pastells-Peiró R, Espigares-Tribó G, Gea-Sánchez M, Rubinat-Arnaldo E. The role of nurses in euthanasia: a scoping review. Int J Nurs Stud. 2022;134:104286. doi:10.1016/j.ijnurstu.2022.104286.
González-Rincón M, Díaz de Herrera-Marchal P, Martínez-Martín ML. Rol de la enfermera en el cuidado al final de la vida del paciente crítico. Enferm Intensiva. 2019;30(2):78-91. doi:10.1016/j.enfi.2018.02.001.
Dierckx de Casterlé B, Verpoort C, De Bal N, Gastmans C. Nurses' views on their involvement in euthanasia: a qualitative study in Flanders (Belgium). J Med Ethics. 2006;32(4):187-92. doi:10.1136/jme.2005.011783.
Taheri-Ezbarami Z, Jafaraghaee F, Sighlani AK, Mousavi SK. Core components of end-of-life care in nursing education programs: a scoping review. BMC Palliat Care. 2024;23:82. doi:10.1186/s12904-024-01398-3.
Ghaemizade Shushtari SS, Molavynejad S, Adineh M, Savaie M, Sharhani A. Effect of end-of-life nursing education on the knowledge and performance of nurses in the intensive care unit: a quasi-experimental study. BMC Nurs. 2022;21:102. doi:10.1186/s12912-022-00880-8.
Cayetano-Penman J, Malik G, Whittall D. Nurses' perceptions and attitudes about euthanasia: a scoping review. J Holist Nurs. 2021;39(1):66-84. doi:10.1177/0898010120923419.
Pesut B, Greig M, Thorne S, Storch J, Burgess M, Tishelman C. Nursing and euthanasia: a narrative review of the nursing ethics literature. Nurs Ethics. 2020;27(1):152-67. doi:10.1177/0969733019845127.
Velasco Sanz TR, Cabrejas Casero AM, Rodríguez González Y, Barbado Albaladejo JA, Mower Hanlon LF, Guerra Llamas MI. Opinions of nurses regarding euthanasia and medically assisted suicide. Nurs Ethics. 2022;29(7-8):1721-38. doi:10.1177/09697330221109940.
Satriani NLA, Sani AW, Wangi NLPA, Cahyadi HS, Abdurrahman F, Dewi KHY. Nurses perception and role of euthanasia: a literature review. Babali Nurs Res. 2024;5(2):362. doi:10.37363/bnr.2024.52362.
Arreciado Marañón A, García-Sierra R, Busquet-Duran X, Tort-Nasarre G, Feijoo-Cid M. Nursing students' attitude toward euthanasia following its legalization in Spain. Nurs Ethics. 2025;32(2):412-23. doi:10.1177/09697330241238342.
Bachmetjev B, Airapetian A, Jakubauskienė M, Zablockis R, Čekanauskaitė A. Demographic influences on Lithuanian physicians' attitudes toward medical assistance in dying: a cross-sectional study. Front Psychiatry. 2024;15:1507790. doi:10.3389/fpsyt.2024.1507790.
Mroz S, Daenen F, Dierickx S, Mortier F, De Panfilis L, Ghirotto L, Campbell T, Chambaere K, Deliens L. What do physicians want at the end? An international qualitative study on physicians' personal end-of-life preferences and what influences them. Palliat Care Soc Pract. 2025;19:e001351349. doi:10.1177/26323524251351349.
Demedts D, Magerman J, Goossens E, Tricas-Sauras S, Bilsen J, De Smet S, Fobelets M. Using simulation to teach nursing students how to deal with a euthanasia request. PLoS One. 2024;19(3):e0299049. doi:10.1371/journal.pone.0299049.
Bermúdez-Tamayo C, Negrín MA, Alvarez-Dardet C, López Franco MA, Latasa Zamalloa P. Colaboración entre las revistas de Salud Pública en España. Rev Esp Salud Publica. 2020;94:e202002013. https://www.scielosp.org/article/resp/2020.v94/202002013/.
Skedsmo K, Nes AAG, Stenseth HV, Hofsø K, Larsen MH, Hilderson D, Smis D, Lundh Hagelin C, Olaussen C, Solberg MT, Bingen HM, Ølnes MA, Steindal SA. Simulation-based learning in palliative care in postgraduate nursing education: a scoping review. BMC Palliat Care. 2023;22:30. doi:10.1186/s12904-023-01149-w.
Condry HM, Kirkpatrick AJ. Simulation in end-of-life nursing education: a literature review. Clin Simul Nurs. 2021;59:98-110. doi:10.1016/j.ecns.2021.06.005.
Yoong SQ, Schmidt LT, Devi KM, Zhang H. Using palliative and end-of-life simulation to enhance pre-licensure nursing students' emotional intelligence, palliative care knowledge and reflective abilities: a single group, pretest-posttest study. Nurse Educ Today. 2023;130:105923. doi:10.1016/j.nedt.2023.105923.
Miranda Gonçalves R. Reflexiones finales sobre la eutanasia: un recorrido a través de sus dimensiones médicas, éticas y legales. Prolegómenos. 2024;27(53):107-22. doi:10.18359/prole.7031.
Verhofstadt M, Van Assche K, Sterckx S, Audenaert K, Chambaere K. Psychiatric patients requesting euthanasia: guidelines for sound clinical and ethical decision making. Int J Law Psychiatry. 2019;64:150-61. doi:10.1016/j.ijlp.2019.04.004.
Simon A. Ethical issues concerning patient autonomy in clinical practice. In: Kühler M, Mitrović VL, editors. Theories of the self and autonomy in medical ethics. Cham: Springer; 2020. p. [páginas]. doi:10.1007/978-3-030-56703-3_8.
Ministerio de Salud y Protección Social. Resolución 2665 de 2018, por medio de la cual se reglamenta parcialmente la Ley 1733 de 2014 en cuanto al derecho a suscribir el Documento de Voluntad Anticipada. Bogotá; 2018. https://www.minsalud.gov.co/Normatividad_Nuevo/Resolución%20No.%202665%20de%202018.pdf.
Abikan YI. Examining the legality or otherwise of euthanasia under Nigerian law and Islamic law [Internet]. Crescent Univ Law J. 2025;10:120-38. Consultado Oct 20, 2025. https://bacolaw.edu.ng/wp-content/uploads/2025/08/14.-Abikan-Examining-the-Legality-or-otherwise-of-Euthanasia.pdf.
Omipidam BA. Palliative care: an alternative to euthanasia. BMJ Support Palliat Care. 2013;3(2):229-30. doi:10.1136/bmjspcare-2013-000491.13.
Faronbi JO, Akinyoola O, Faronbi GO, Bello CB, Kuteyi F, Olabisi IO. Nurses' attitude toward caring for dying patients in a Nigerian teaching hospital. Sage Open Nurs. 2021;7. doi:10.1177/23779608211005213.
Leboul D, Bousquet A, Chassagne A, Mathieu-Nicot F, Ridley A, Cretin E. Understanding why patients request euthanasia when it is illegal: a qualitative study in palliative care units on the personal and practical impact of euthanasia requests. Palliat Care Soc Pract. 2022;16. doi:10.1177/26323524211066925.
Berenguel M, Buendia D, Tejada P, Manrique M, Perez L, Gil-Olivares F, Serrano M, Aliaga K. Guía de práctica clínica para el manejo del dolor en pacientes oncológicos de una red de clínicas privadas, Lima - Perú. Rev Cuerpo Med HNAAA. 2022;15(1):118-25. doi:10.35434/rcmhnaaa.2022.151.1184.
Alcántara Montero A, Ibor Vidal PJ, Alonso Verdugo A, Trillo Calvo E. Actualización en el tratamiento farmacológico del dolor neuropático. Med Fam SEMERGEN. 2019;45(8):535-45. doi:10.1016/j.semerg.2019.05.008.
World Health Organization. WHO guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents. Geneva: World Health Organization; 2018. Consultado Oct 22, 2025. https://www.ncbi.nlm.nih.gov/books/NBK537492/.
Storm E, Bergdahl E, Tranvåg O, Korzhina Y, Linnanen C, Blomqvist H, Hemberg J. Palliative nurses' experiences of alleviating suffering and preserving dignity. Nurs Ethics. 2025;32(7):2018-32. doi:10.1177/09697330251326235.
Combrinck Y, Van Wyk NC, Mogale RS. Preserving nurses' professional dignity: six evidence-based strategies. Int Nurs Rev. 2022;69(1):106-13. doi:10.1111/inr.12701.
Sandham M, Carey M, Hedgecock E, Jarden R. Nurses' experiences of supporting patients requesting voluntary assisted dying: a qualitative meta-synthesis. J Adv Nurs. 2022;78(10):3101-15. doi:10.1111/jan.15324.
Wibisono S, Mavandadi P, Wilkinson S, Amiot C, Forbat L, Thomas EF, Allen F, Decety J, Noonan K, Minto K, Breen LJ, Kho M, Crane M, Lizzio-Wilson M, Molenberghs P, Louis W. More support, less distress?: examining the role of social norms in alleviating practitioners' psychological distress in the context of assisted dying services. Death Stud. 2025;49(4):427-38. doi:10.1080/07481187.2024.2337189.
Nissim R, Chu P, Stere A, Tong E, An E, Selby D, Hales S. Walk me through the final day: a thematic analysis study on the family caregiver experience of the Medical Assistance in Dying procedure day. Palliat Med. 2024;38(6):660-8. doi:10.1177/02692163241248725.
Erazo-Muñoz M, Borda-Restrepo D, Benavides-Cruz J. Euthanasia in Colombia: experience in a palliative care program and bioethical reflections. Dev World Bioeth. 2024;24(4):310-7. doi:10.1111/dewb.12430.
Corte Constitucional de Colombia. Sentencia C-239 de 1997 [Internet]. Bogotá: Corte Constitucional de Colombia; 1997 May 20. Consultado Oct 25, 2025. https://www.corteconstitucional.gov.co/relatoria/1997/c-239-97.htm.
Corte Constitucional de Colombia. Sentencia T-970 de 2014 [Internet]. Bogotá: Corte Constitucional de Colombia; 2014 Dec 15. Consultado Oct 25, 2025. https://vlex.com.co/vid/690590493.
Corte Constitucional de Colombia. Sentencia C-233 de 2021 [Internet]. Bogotá: Corte Constitucional de Colombia; 2021 Jul 22. Consultado Oct 25, 2025. https://www.alcaldiabogota.gov.co/sisjur/normas/Norma1.jsp?i=117745.
Ministerio de Salud y Protección Social. Resolución 971 de 2021 [Internet]. Bogotá: Ministerio de Salud; 2021. Consultado Oct 28, 2025. https://sisjur.bogotajuridica.gov.co/sisjur/normas/Norma1.jsp?i=114617&dt=S.
Durojaiye A, Ryan R, Doody O. Student nurse education and preparation for palliative care: A scoping review. PLoS One. 2023;18(7):e0286678. doi: 10.1371/journal.pone.0286678.
Busquets-Surribas M. La relevancia ética del cuidado enfermero en la eutanasia y el suicidio asistido. Enferm Clin. 2021;31(5):266-7. doi:10.1016/j.enfcle.2021.08.001.
Krol P, Hudon E, Paquet O. Medical aid in dying: a foreseen decisive role for the specialized nurse practitioner in Quebec. J Nurs Educ Pract. 2023;13(3):61. doi:10.5430/jnep.v13n3p61.
Downloads
Published
Issue
Section
License
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
