A meta-synthesis exploring nurses' experiences of assisted dying and participation decision-making

Aims and ObjectivesTo explore nurses' experiences of assisted dying and understand how their perspectives inform their participation decision-making.BackgroundAssisted dying is a complex and contentious issue with the potential to create moral unrest for nurses. The nursing role in assisted dying varies between jurisdictions.DesignSystematic review. A meta-synthesis using thematic analysis.MethodsThree electronic databases were searched for primary qualitative studies published in English, from New Zealand, Australia or Canada, up to October 2022. Seven articles were included; themes were analysed and key themes were established. Reporting adhered to PRISMA.ResultsThe findings highlight the complexity of nurses' decision-making about participation or non-participation in assisted dying and the moral, philosophical and social influences that impact on their decision-making. This is presented as a spectrum of influence which persuades or dissuades nurses to participate in assisted dying. The 12 themes have been categorised into four key themes: personal persuaders, personal dissuaders, professional persuaders and professional dissuaders.ConclusionsThe findings suggest that nurses should be involved in policy and procedure guideline development and be offered education and training programmes to ensure safe, confident and informed practice. The need for mentorship programmes was also prevalent in the research.Relevance to Clinical PracticeIt is crucial that nurses be offered education and training in assisted dying. Clear policy and procedure guidelines are essential, and nurses should be involved in the development of these.