Euthanasia and Palliative Care in Belgium: The Attitudes of Flemish Palliative Care Nurses and Physicians Toward Euthanasia

Little research has been carried out to determine the attitudes of palliative care professionals to euthanasia. This research aimed to find out how Flemish palliative care nurses and physicians think about euthanasia. An anonymous questionnaire was sent to all physicians (147) and nurses (589) employed in palliative care teams and institutions in Flanders (Belgium). The questionnaire contained a demographic part, and an attitudinal part, consisting of a long series of ethical statements using a 5-point Likert-scale. Four hundred fifteen nurses (response rate 70.5%) and 99 physicians (67.3%) responded. A cluster analysis of the euthanasia questions resulted in three clusters: (moderate) opponents of euthanasia (n = 105, 23%), moderate advocates of euthanasia (n = 161, 35.2%), and staunch advocates of euthanasia (n = 191, 41.8%). A majority in all clusters believe that as soon as a patient experiences the benefits of good palliative care, most requests for euthanasia disappear and that all palliative care alternatives must be tried before a euthanasia request can be considered. Being a member of the cluster of the (moderate) opponents of euthanasia is associated with being male (p = .01), being older (p = .05), increasing years of experience in palliative care (p = .02), and being a physician (p = .02). Since most Flemish palliative care nurses and physicians are not absolutely against voluntary euthanasia, their attitudes seem to differ from the attitudes of their palliative care colleagues elsewhere. However, the attitudes of the Flemish palliative care nurses and physicians are largely contextual. For a very large majority, euthanasia is an option of last resort only.