This article reports on a survey of the moral problems that Dutch nurses experience during their everyday practice. A questionnaire was developed, based on published literature, panel discussions, in-depth interviews and participation observations. The instrument was tested in a pilot study and proved to be useful. A total of 2122 questionnaires were sent to 91 institutions in seven different health care settings. The results showed that nurses were not experiencing important societal issues such as abortion and euthanasia as morally the (...) most problematic, but rather situations such as verbally aggressive behaviour of colleagues towards patients, keeping silent about errors, and medical treatment given against the wishes of patients. Moral problems occurred especially when nurses experienced feelings of powerlessness with regard to the well-being of patients. Moreover, these moral problems proved to be related to institutional organization, leadership, and collaboration with colleagues and other disciplines. Nurses appeared to have a limited awareness of the moral dimensions of their practice. (shrink)

This article reports on a survey of the moral problems that Dutch nurses experience during their everyday practice. A questionnaire was developed, based on published literature, panel discussions, in-depth interviews and participation observations. The instrument was tested in a pilot study and proved to be useful. A total of 2122 questionnaires were sent to 91 institutions in seven different health care settings. The results showed that nurses were not experiencing important societal issues such as abortion and euthanasia as morally the (...) most problematic, but rather situations such as verbally aggressive behaviour of colleagues towards patients, keeping silent about errors, and medical treatment given against the wishes of patients. Moral problems occurred especially when nurses experienced feelings of powerlessness with regard to the well-being of patients. Moreover, these moral problems proved to be related to institutional organization, leadership, and collaboration with colleagues and other disciplines. Nurses appeared to have a limited awareness of the moral dimensions of their practice. (shrink)

In the Netherlands, euthanasia and assisted suicide are formally forbidden by criminal law, but, under certain strictly formulated conditions, physicians are excused for administering these to patients on the basis of necessity. These conditions are bound up with a long process of criteria development. Therefore, physicians still live in uncertainty. Future court decisions may change the criteria. Apart from that, physicians can always be prosecuted. The position of nurses, however, is perfectly clear; they are never allowed to administer euthanasia or (...) assisted suicide. Nevertheless, they should be involved in the decision-making process because they are an important source of information and have consultation skills. The openness of the discussion about these issues in the Netherlands may prevent an escalation of medical or nursing responsibility and falling victim to the ‘slippery slope’. (shrink)