Nurses' perspectives on assisted suicide: Challenges and support needs

Background: Assisted suicide, also known as physician-assisted death, remains a contentious issue for healthcare providers, involving medical ethics, legal frameworks, and individual rights. This study aims to explore the attitudes, experiences, and training needs of nurses in Austria following the legalization of assisted suicide in 2022. Methods: Utilizing a cross-sectional online survey, both quantitative and qualitative data were collected from 280 palliative and hospice care nurses across all nine Austrian states. Results: Approximately a quarter of nurses experienced a shift in their attitudes towards assisted suicide during the first year of its legalization. While a majority felt their wellbeing was unaffected, 14.5% reported a decline in mental health due to the new law. Despite both mandatory and optional training being provided by employers, 80.7% of nurses expressed a need for further education, particularly on legal and organizational aspects, practical case studies, and interdisciplinary communication. Qualitative analysis revealed diverse perspectives, with some nurses advocating for patient autonomy and empathetic support, while others preferred enhancing palliative care as an alternative to assisted suicide. Furthermore, nurses highlighted the necessity for a clear legal framework and collaborative decision-making processes. Conclusion: The study underscores the critical role of comprehensive palliative care and calls for more clarity around appropriate assisted suicide practices. Ongoing dialogue, enhanced training, and support for nurses to navigate both ethical and practical challenges posed by assisted suicide legislation is also needed. Future research should evaluate the effectiveness of these interventions and explore the long-term impacts of assisted suicide on patients, their families, and healthcare providers.