This volume provides a critical introduction to contemporary attempts to base nursing ethics on a feminine 'ethics of care'.

This study was conducted to gain opinions about euthanasia from nurses who work in intensive care units. The research was planned as a descriptive study and conducted with 186 nurses who worked in intensive care units in a university hospital, a public hospital, and a private not-for-profit hospital in Adana, Turkey, and who agreed to complete a questionnaire. Euthanasia is not legal in Turkey. One third (33.9%) of the nurses supported the legalization of euthanasia, whereas 39.8% (...) did not. In some specific circumstances, 44.1% of the nurses thought that euthanasia was being practiced in our country. The most significant finding was that these Turkish intensive care unit nurses did not overwhelmingly support the legalization of euthanasia. Those who did support it were inclined to agree with passive rather than active euthanasia (P = 0.011). (shrink)

Creating what sort of professional? Master's level nurse education as a professionalising strategy This paper reports on a detailed analysis of selected findings from a larger study of master's level nurse education. It locates some features of such education within the contemporary situation of nursing as a profession and interprets the role of master's level nurse education as a professionalising strategy. In‐depth interviews were undertaken with a purposive sample of 18 nurse lecturers drawn from eight universities in the United Kingdom. (...) The interview agenda explored participants’ perspectives of the characteristics of master's level performance in practice. Interview transcripts were interpreted by drawing upon hermeneutic methodology.The following themes emerged. (a) The credibility of the master's level nurse was of central importance. In terms of the literature of professionalisation, this may be interpreted as a factor in enhancing the legitimacy of nursing as an occupation. (b) The clinical capability attributed to the nurse is interpreted as leading to an increase in the authority commanded by the expert professional. Thus, the individual capability of the master's level nurse enhances the attribution of autonomous skill to the occupation as a whole. (c) The master's level nurse is seen to exercise influence and leadership and this strengthens the power and status of nursing.Nursing does not have the appearance of a ‘traditional’ profession, neither has it a clear stance as a ‘new profession’. Rather it appears to be especially responsive to the tide of public opinion manifest through government edicts. While nursing is employing rhetoric that espouses both positions, the direction of master's level education is anomalous. (shrink)

Nurses are the closest healthcare providers to patients and emotional labor is the most invisible part of nursing work. However, the management of emotions to promote organizational goals and to ensure patient satisfaction may have both positive and negative impacts on nurses' working life. The purpose of this cross‐sectional, descriptive study was to examine the emotional labor behaviors of nurses and their opinions on emotional labor. Two hundred nineteen nurses working at public hospitals in Ankara (...) between September and December 2018 participated to this study. Data were collected using the sociodemographic characteristics form and “The Scale of Emotional Labor Behavior for Nurses.” Nurses had higher scores on the deep and sincere emotional acting subdimensions of the emotional labor scale than the surface acting subdimension. Findings suggest that nurses act deeply and intimately, instead of surface acting. Most of the nurses expressed that nurses were emotionally affected when caring for patients; however, nurses had to control their feelings toward patients and behave professionally to meet the expectations of their managers, which may lead to an implicit emotional dissonance. Based on the results of this study, we suggest to support nurses emotionally and to incorporate the topic of emotional labor into educational programs. (shrink)

ObjectivesThe study evaluated nurses’ perceptions on the benefits, drawbacks, and their roles in initiating and implementing advance directives at private and public secondary healthcare units.MethodsThe study adopted a cross-sectional, comparative-descriptive research design and was anchored on the structural functional theory. A total of 401 nurses were chosen on purpose. The data was collected between January and March 2018 among nurses at the selected hospitals. Analysis was done via SPSSv28.0.1.0.ResultsCompared to nurses working in private healthcare facilities, (...) the majority of nurses at the public healthcare facilities indicated a more favorable opinion of AD’s benefits and felt they had a substantial involvement in the development and execution of AD than their private counterpart. Similarly, 60.7% of nurses employed by the government agreed that AD has some disadvantages compared to those employed by the private sector. Significantly, Christian nurses are 0.53 times less likely than Muslims to contest AD’s benefits; 0.78 times less likely than Muslim to disagree that AD has flaws; and 1.30 times more likely than Muslim nurses to deny they contributed to the development and execution of AD, though not significant.ConclusionMaking decisions at the end-of-life can be challenging, thus AD should be supported across the board in the healthcare industry. Nurses should be trained on their role in developing and implementing AD, as well as on its advantages and how to deal with its challenges. (shrink)

A paper was published in 2003 discussing the ethics of nurses participating in executions by inserting the intravenous line for lethal injections and providing care until death. This paper was circulated on an international email list of senior nurses and academics to engender discussion. From that discussion, several people agreed to contribute to a paper expressing their own thoughts and feelings about the ethics of nurses participating in executions in countries where capital punishment is legal. While a (...) range of opinions were presented, these opinions fell into two main themes. The first of these included reflections on the philosophical obligations of nurses as caregivers who support those in times of great need, including condemned prisoners at the end of life. The second theme encompassed the notion that no nurse ever should participate in the active taking of life, in line with the codes of ethics of various nursing organisations. This range of opinions suggests the complexity of this issue and the need for further public discussion. (shrink)

Nursing has evolved, yet media representation has arguably failed to keep up. This work explores why representation has been slow in accurately depicting nurses' responsibilities, impacts on public perceptions and professional identity. A critical realist review was employed as this method enables in-depth exploration into why something exists. A multidisciplinary approach was adopted, drawing from feminist, psychological and sociological theories to provide insightful understanding and recommendations. One main feminist lens has been implemented, using Laura Mulvey’s ‘Male-Gaze’ framework for (...) content analysis of three nurse-related advertisements to explore how the profession's female status influences representation, public perception and how this might impact nursing. Nurse representation has important real-world consequences. It is essential to improve unnecessary negative portrayals and contest ingrained stereotypes as there are costs to public opinion and nursing's self-identity. Nursing's female status has an impact within a male-dominated media industry, with a leisurely approach adopted toward changing representation. Media images become societally ingrained, this reiterates the significance of accurate/positive depictions. Social media is an instant method of communication with the public to combat stereotypes and maintain engagement to provide better understanding of what nurses do. (shrink)

Background: Essential for the help relation, empathy is the ability to understand, share, and perceive the subjective experience of other human beings. Objective: The objective in this non-experimental, exploratory, and descriptive research was to verify, observe, and document empathy in nursing professionals. Research design: Non-experimental, exploratory, and descriptive research. Participants and research context: the study was conducted at two large hospitals, one public and the other private, across all shifts. The sample included 159 individuals. A questionnaire was used to (...) identify sociodemographic characteristics and the empathy inventory was applied. Ethical considerations: This study received approval from the Research Ethics Committee at the University of São Paulo at Ribeirão Preto College of Nursing, opinion 1348/2011, and authorization from the health institutions involved. Findings: The association tests demonstrated that professionals working in the night shift and in a work scale rotation scheme, older professionals, and professionals with longer professional experience are less empathetic. On the other hand, professionals working in the day shift and in a single shift are more empathetic. Other influential factors are the time on the job, education, and work shift. Conclusion: There is a lack of empathy studies in professional practice contexts, in human resource development programs, and throughout the professional education process. (shrink)

Objective To determine the knowledge and attitudes of healthcare personnel regarding the provision of non-beneficial futile care in the intensive care units at the major public hospitals in Trinidad and Tobago. Method Prospective data collection was done using a questionnaire administered to the medical and nursing staff of the intensive care units. The questionnaire was designed to capture the opinions regarding the futile care offered to terminally ill patients at the intensive care units. The responses were based on a (...) five-point Likert scale. The influence of factors such as age, gender, duration of work experience, religious belief, ethnicity, occupational category and educational status on the responses were analysed. Results A total of 274 completed responses were obtained from doctors and nurses. The frequency with which the respondents encountered ethical or legal problems in the intensive care unit varied widely from ‘daily’ to ‘yearly’. The majority felt that knowledge of ethics is important, and only 32% knew the legal issues pertaining to their work. Eighty percent of doctors and nurses had no knowledge of an existing Hospital Ethics Committee and its role in ethical dilemmas. Although 62% said their decisions regarding futile care will be influenced by their scientific knowledge, only 32% agreed to withdraw care. Eighty percent said that the government should pass appropriate laws regarding withdrawal of futile care. Conclusions Most healthcare providers in intensive care unit are not knowledgeable in the ethical and legal issues of non-beneficial futile care. There is a need to devise means to bring awareness and educate intensive care unit healthcare providers in this subject. (shrink)

GILLETT K. Nursing Inquiry 2012; 19: 297–307 A critical discourse analysis of British national newspaper representations of the academic level of nurse education: too clever for our own good?This critical discourse analysis examines articles about the academic level of nurse education that appeared in British national newspapers between 1999 and 2009. British newspaper journalists regularly attribute problems with recruitment into nursing and nursing care to the increasing academic nature of nurse education. It is impossible to separate discourse about nurse education (...) from the wider nursing discourse. Many journalists laud a traditional and stereotypical construct of nurse identity and suggest that increasing nurse education produces nurses who are ‘too clever to care’. This article argues that whilst nurses lack a voice in the National press, they have little input into the construction of newspaper discourse about nurse education and subsequently, limited influence on resulting public opinion, government policy and the morale of nurses. (shrink)

Continuous sedation until death (CSD), the act of reducing or removing the consciousness of an incurably ill patient until death, often provokes medical-ethical discussions in the opinion sections of medical and nursing journals. A content analysis of opinion pieces in medical and nursing literature was conducted to examine how clinicians define and describe CSD, and how they justify this practice morally. Most publications were written by physicians and published in palliative or general medicine journals. Terminal Sedation and Palliative Sedation are (...) the most frequently used terms to describe CSD. Seventeen definitions with varying content were identified. CSD was found to be morally justified in 73 % of the publications using justifications such as Last Resort, Doctrine of Double Effect, Sanctity of Life, Autonomy, and Proportionality. The debate over CSD in the opinion sections of medical and nursing journals lacks uniform terms and definitions, and is profoundly marked by ‘charged language’, aiming at realizing agreement in attitude towards CSD. Not all of the moral justifications found are equally straightforward. To enable a more effective debate, the terms, definitions and justifications for CSD need to be further clarified. (shrink)

BackgroundWhile healthcare professionals’ right to invoke the conscience clause has been recognised as a fundamental human right, it continues to provoke a heated debate in Polish society. Although public discourse is filled with ethical and legal considerations on the conscience clause, much less is known about the attitudes of healthcare professionals regarding that matter. The aim of this study was therefore to describe the attitudes of Polish physicians, nurses and pharmacists towards the ethical and legal aspects of the (...) conscience clause.MethodsWe analysed a group of three hundred healthcare professionals: physicians, nurses and pharmacists in Poznan, Poland, using a standard questionnaire comprising of 29 questions about various ethical and legal aspects of the conscience clause and participants’ personal experiences with the conscience clause. The study was conducted between January and March 2020.ResultsThis research shows that although most Polish healthcare workers support the right to invoke the conscience clause they differ significantly in their opinions on to whom and to what medical procedures the conscience clause should apply to. It also demonstrated that while the conscience clause is rarely invoked in Poland, most healthcare professionals declare that the current legal regulations in that sphere are unclear and inaccurate.ConclusionsWhile there is an urgent need to raise the awareness regarding the conscience clause among medical students and healthcare professionals and educate them about such issues, it is even more important to improve the legal system in regard to the CC so that it protects both HCPs’ right to the CC and safeguards patients’ rights to medical services. (shrink)

Background: Nurses are in a key position for reproduction health service delivery. Therefore, it is thought that it would be important to inspect opinions of student nurses, who will be health employees in the future, about self-induced abortion to develop women health and public health. Objectives: The goal of this study is to inspect opinions of nursing students with different sociocultural specialties, about self-induced abortions. Research design: It is qualitative type and planned with ethnographic research pattern. Participants (...) and research context: The study was conducted with 20 last-term students of Kırşehir Ahi Evran University, Faculty of Health Sciences, Department of Nursing, who were chosen by maximum diversity sampling technique. Interviews were made with semi-structured interview form and voice records during the study; data were analyzed with content analyzing method. Ethical considerations: Permission from the organization, university ethics committee, and personal approvals were taken from participants to conduct the research. Findings: Based on the analysis, two major themes on self-induced abortion in Turkish nursing students were found: dilemma of traditional perspective and professional identity and occupational awareness. Discussion and conclusion: It is seen that there is a dilemma between traditional point of view and professional identities about self-induced abortion for nursing students, but they had occupational awareness. It should be recommended to give information about national and international licit legislations for reproductive health, self-induced abortion, and setting up ethical discussion environments for nursing students. (shrink)

In 1992, Eluana Englaro was involved in a car accident in Italy that eventually left her in a permanent vegetative state requiring artificial nutrition and hydration. This paper, after briefly reviewing Eluana's case, gives a chronicle of Eluana last months until her death on 9 February 2009, and discusses the right-to-die controversy in Italy. For many years, Mr Englaro, Eluana's father, would litigate to enforce what he considered to be his daughter's wish to discontinue life-prolonging treatment. In July 2008, the (...) Court of Appeal of Milan has given its authorisation for artificial life support to be withdrawn. This ruling sparked a crusade, led by the government and the Vatican, against the court and Eluana's father, which included insinuations that the latter was murdering his daughter. Public opinion has overwhelmingly been sympathetic to the father's difficult decision, in stark contrast to the reactionary stance taken by the government. With the notable advances of medicine, doctors are increasingly faced with ethical issues. The vegetative state is just one of the many clinical conditions that obligate health professionals to reflect on ethical matters. The withdrawal of life-supporting care, and of artificial nutrition and hydration in particular in permanent vegetative state patients remains a measure which violates a tradition and a consolidated practice. It was thus inevitable that it would create great controversy. We should work towards making a decision process that ensures that continuation or suspension of artificial nutrition and hydration follows an explicit procedure, promoting the sharing and respect of the diverse moral responsibility of family members, nursing and medical staff. (shrink)

Photo by Hannah Busing on Unsplash INTRODUCTION Religion has long provided guidance that has led to standards reflected in some aspects of medical practices and traditions. The recent bioethical literature addresses numerous new problems posed by advancing medical technology and demonstrates an erosion of standards rooted in religion and long widely accepted as almost axiomatic. In the deep soul-searching that pervades the publications on bioethics, several disturbing and dangerous trends neglect some basic lessons of philosophy, logic, and history. The bioethics (...) discourse on medical aid in dying emphasizes similarity over previously recognized important distinguishing features. For example, it overplays a likeness between assistance in dying and the withdrawal of life-saving technology. In many bioethics’ topics, arguments based on a logical continuum are used to question the lines demarcating important moral differences. l. The Line Between Ethical and Not: Logic Based on Continuum Careful case selection, often either end of a continuum, allows the tearing down or ridiculing of many rules and codes across most professions and fields of interest. This situation holds true for traffic laws as well as medical ethics guidelines. It is relatively simple for those who desire to attack a particular viewpoint by selecting a case that makes that position seem untenable. In the ethics realm, good and bad medicine exist at opposite ends of an ethical continuum, with many practices lying in between. For example, much of medical ethics exists between the Nazi criminal physicians and the most sainted nurse or physician. A gradual progression occurred over less than two decades from a utilitarian position that supported limited euthanasia for those with certain mental illnesses to genocide. German society embraced a utilitarian ethic in which the value of human life no longer was intrinsic but instrumental.[1] Many morally significant points on a continuum were then ignored as the misguided utilitarian policy rampantly continued. A point in the continuum to distinguish between ethically justifiable and that which is not can be difficult to identify compared to the two extremes. This continuum is not unique to ethics but can be applied to almost any other aspect of human life and endeavor. Between a severely ill schizophrenic person and a superbly well-adjusted individual, there is a continuum of mental and psychological function. The existence of a continuum should not paralyze thinking and prevent us from drawing lines and identifying moral differences based on objective criteria as well as moral philosophy. Yet, by focusing on a continuum, many bioethicists use logic to disregard dividing lines between an "ethical" and an "unethical" act. Unfortunately, sometimes bioethicists draw revolutionary conclusions that would change the scope of medical practices which is accepted as ethical. There are many examples of similar shifts on the continuum. Many authors argue for the ethical permissibility of abortion by pointing out that the human fetus is no different in various characteristics, one arguing it is as like an ape or chick as it is like a person,[2] and does not achieve unique human and individual characteristics until well into the first year of life.[3] While human fetuses arguably do not have certain distinctive qualities of personhood, most people shy away from the logical next conclusion: permitting infanticide. For example, Joshua Lederberg condemns infanticide, in the face of biological illogic, because of our emotional commitment to infants, to me, a relatively weak explanation. Sir Francis Crick suggests we might consider birth at two days of life in order to decide whether an infant is a "suitable" member of society.[4] Giublini and Minerva suggest that infanticide should be permissible since late pregnancy abortions are permissible, arguing there is no significant difference between a fetus just before birth and an infant just after birth.[5] Clearly the continuum approach would allow for subjective arguments in favor of later infanticide at other points many days post-birth. Years ago, with a cynical tone, I mentioned infanticide as a further step on the continuum beyond abortion, and I was rightly shouted down as being deliberately provocative to assert the logic would ever stretch so far. While it is not an accepted mainstream position, the movement in academic settings from widespread condemnation to limited possible acceptance of infanticide has taken place in an incredibly short time. Public opinion and medical opinion in these areas have shifted dramatically in a short time. In another area, from a biological and chemical point of view, there is a continuum from man down to a single carbon atom. Yet, it would not seem logical to ignore the emotional differences, the meaning of personhood, or the moral distinction between killing an insect and killing a person. ll. A False Continuum: Medical Aid in Dying I assert that there has been an erosion of ethical guidelines in recent years attributable to using continuums to camouflage important distinctions. James Rachels’ work on active and passive euthanasia, which contends that the two are ethically identical, exemplifies that logic.[6] He illustrates this thesis, using a continuum to compare different scenarios with like consequences as morally equivalent, by comparing the deliberate drowning of a child with a deliberate failure to rescue a drowning child when easily able to do so. The author's comparison proposes that since much of the medical profession has already made peace with withholding treatment in order to hasten death, consistency inexorably demands that we permit active euthanasia as well.[7] When permission for active euthanasia was first introduced, it was limited exclusively to patients suffering severely from an intractable, incurable, and irreversible disease. These guidelines have been continuously eroded. There is now a substantial serious consideration for permitting active euthanasia of healthy elderly individuals who feel that they have completed their lives and are "tired of living."[8] There are many moral and factual differences along the ethical continuum. In human life, there is a difference between a live baby and a fetus, between a viable fetus and one that is not, between a fetus and a zygote, and between a zygote and a sperm cell. Similarly, there is a difference between pulling a trigger to kill someone and not interfering in preventing his death, which is reprehensible though both may be. There is a difference between not resuscitating an 80-year-old man with cancer when his heart stops and injecting him with a fatal dose of potassium chloride. I argue that an overt act of taking life repels civilized human beings is to be commended and encouraged as the reverence for human life or even for just a moment of human life is one of the great contributions of our civilization. CONCLUSION As an orthodox Jew, I feel that divinely inspired guidelines that have stood the test of centuries shape my beliefs, and such guidelines contradict medical aid in dying. I cannot speak to the viewpoint of those who do not access religion in defining their moral stance, nor do I implicate them in the current bioethics' trends, as I am not aware of the personal role of religion in the lives of most such authors. While many nonreligious people have a firm philosophical grounding and oppose medical aid in dying, I suggest that in the absence of any religious or other absolute standards, developing logically defensible ethical guidelines may be challenging. At the least, religion may play a role in defining the points on the continuums that are ethically meaningful and refuting the trending beliefs that if the endpoint is the same, allowing different methods of arriving at that end are somehow ethically equal. The continuum of ways death may result does not negate analysis of whether death is brought about in ways that recognize the importance of life. The German philosopher Hans Jonas said, "It is a question whether without restoring the category of the sacred, the category most thoroughly destroyed by the scientific enlightenment, we can have an ethics able to cope with the extreme powers that we possess today and constantly increase and are compelled to use."[9] While countries vary on the role of religion in policy, with many emphasizing freedoms of religion, a recent position paper released by a group of Jewish, Christian, and Moslem leaders suggested the need for agreement on the unique sanctity of human life.[10] I would recommend that such a document serve as an example of consensus on critical foundational bioethical guidelines for democratic secular societies. - [1] Alexander L Medical science under dictatorship. New England Journal of Medicine, 241, p39-47 DOI10.1056/NEJM194907142410201 [2] Lederberg J. A geneticist looks at contraception and abortion, Annals of Internal Medicine 67, sup 2, 25-27. https:/doi.org/10.7326/0003-4819-67-3-25 [3] Ibid. [4] Editorial, Sociology: Logic of biology. Nature 220, 429 https://www.nature.com/articles/220429b0 [5] Giublini A Minerva F After-birth abortion: why should the baby live. J Med Ethics 39, 261- [6] Rachels J Active and passive euthanasia. New England Journal of Medicine 292, 78-80 [7] Ibid. [8] Cohen-Almagor R Euthanizing people who are "tired of life". in Euthanasia and Assisted Suicide-Lessons from Belgium. Ch 11 of Euthanasia and Assisted Suicide, Cambridge University Press pp173-187. 2017 and DOI; https://doi.org/10.1017/9781108182799.012 [9] Hans Jonas, Technology and Responsibility: Reflections on the New Tasks of Ethics, 1972, found as Chapter IX, Philosophical Essays, 1980. https://inters.org/jonas-technology-responsability [10] A position paper of the Abrahamic Monotheistic religions on matters concerning the end-of-life. Vatican Press 28 October 2019 https://press.vatican.va/content/salastampa/en/bollettino/pubblico/2019/10/28/191028f.html. (shrink)

Background Issues of the aging population and disability of older persons have been rapidly developing in China over the past 20 years. Since 2016, the Chinese government has been exploring remedies to alleviate social and family burdens and ensure the dignity of the disabled old persons by implementing long-term care insurance systems in a few pilot cities across the country. Purpose The purpose of this study is to present the current challenges faced by China’s long-term care insurance system and put (...) forth suggestions for the future, based on literature research and the feedback obtained from its implementation in pilot areas. Research Design This paper conducts a theoretical study based on the principles of public health ethics. Study Sample Since 2016, China has launched two batches of pilot cities for long-term care insurance. The analysis object of this study is the feedback on the policy implementation of the existing 29 pilot cities that participated. The relevant data involved in the analysis are from the authors' field research and published literature on the analysis of pilot cities. Analysis The ethical value and importance of long-term care insurance policies in China are evaluated from the perspectives of policy philosophy and social individual interests. Results The results of this evaluation show that the core ethical values were not met in the development of China’s current long-term care insurance system. Moreover, distributive justice norms were neglected, and access to the system between different social groups and within the groups covered by it was unequal. Conclusions This paper argues that long-term care insurance should not differentiate between urban and rural areas in allocating nursing resources. Additionally, it would be essential to build democratic supervision and manage public opinions by adopting open and transparent information-sharing policies. Standards of disability assessments and treatment payment should be at par to ensure a balance between the rights and obligations of policyholders. (shrink)

As a result of the coronavirus (COVID‐19) pandemic, health professionals are faced with situations they have not previously encountered and are being forced to make difficult ethical decisions. As the first group to experience challenges of caring for patients with coronavirus, Chinese nurses endure heartbreak and face stressful moral dilemmas. In this opinion piece, we examine three related critical questions: Whether society has the right to require health professionals to risk their lives caring for patients; whether health professionals have (...) the right to refuse to care for patients during the coronavirus pandemic; and what obligations there are to protect health professionals? Value of care, community expectations, legal obligations, professional and codes of practice may compel health professionals to put themselves at risks in emergency situations. The bioethical principles of autonomy, justice, beneficence and non‐maleficence, as well as public health ethics, guide nurses to justify their decisions as to whether they are entitled to refuse to treat COVID‐19 patients during the pandemic. We hope that the open discussion would support the international society in addressing similar ethical challenges in their respective situations during this public health crisis. (shrink)

This article aims at giving insight into Norwegian mental health service by exploring the ideologies of two diametrical philosophers, the American Robert Nozick (1938–2002) and the German Axel Honneth (1949‐). Nozick proposes as an ideal a minimal state in which citizens have a “negative right” to the absence of interference and to follow their own interests without restriction from the state. On the other side, Axel Honneth claims that there is no freedom without state interference. In his view, governmental involvement (...) is understood as a prerequisite for personal freedom. We may call this state an opposite of the minimal state; a maximal state. To get a better understanding of these opposite philosophies, we use texts written from conversations with people suffering from mental health problems, nurses and other caregivers in four Norwegian municipalities. Nozick's notion of the minimal state and Honneth's political philosophy of freedom and recognition were used as analytical tools. Among patients and helpers, there were different opinions about good care and how much caregivers should intervene. Some emphasized autonomy, independency, minimal involvement in human contact by nurses and other caregivers, similar a minimal state. Others perceived good care as bonding between helpers and service‐users. They underlined equal and personal relationships, as well as helping with practicalities, similar a maximal state. In the discussion, we focus on how people with chronic illnesses are supposed to transform themselves into self‐cared individuals, able to manage their own condition successfully with minimal help from public welfare and at a lower cost. Finally, we express concerns about who will care for disempowered patients without family and other resources in a minimal state. (shrink)

Public health nursing is grounded in public health ideologies and fundamental nursing values. Researchers have argued that ethical responsibility from the perspective of the nurse is an understudied phenomenon. This meta-ethnography provides in-depth knowledge of how public health nurses (PHNs) experience ethical responsibility when working to prevent injury and disease, and promote health and well-being in children, young people and their families. There are reciprocal findings across the 10 included studies. The findings reveal that these (...) class='Hi'>nurses often feel alone, have worries and uncertainties and are afraid of doing wrong. They describe unclear boundaries in their work, creating a heightened sense of responsibility. PHNs fight lonely battles. Yet they show courage and commitment and are ready to stand up and fight for children and families who do not receive adequate care. A line of argument is developed and the metaphorical phrase Chivalrous knights in moral armour is used to express the authors’ overall interpretations of the findings. Reflection on the findings shows how the different dimensions of ethical responsibility are interconnected. The nurses’ ethical sensitivity enables them to feel compassion for others and they show indignation when vulnerable others are not treated with dignity and respect. Indignation and compassion are interrelated, and when human life and dignity are threatened, the ethical demand to respond emerges. Indignation is a precursor to moral courage, and the nurses’ moral sensitivity and respect for their clients emboldens them to stand up for vulnerable others. The findings also illustrate the paradoxical nature of freedom. Freedom of choice due to unclear boundaries heightens the nurses' sense of responsibility. This research is an important step in theory development and has implications for further research, education and practice. (shrink)

Background Safeguarding the right to die according to the principles of autonomy and freedom of each person has become more important in the last decade, therefore increasing regulation of Euthanasia and Medically Assisted Suicide (MAS). Aims To learn the opinions that the nurses of the autonomous region of Madrid have regarding Euthanasia and Medically Assisted Suicide. Research design Cross-sectional descriptive study. Participants and research context All registered nurses in Madrid. The study was done by means of a self-completed (...) anonymous questionnaire. The variables studied were social-demographic, giving opinions about Euthanasia and MAS. Ethical considerations Each participant was assured maximum confidentiality and anonymity, ensuring the ethical principles set out in the Declaration of Helsinki, as well as in the Organic Law 3/2018, on Personal Data Protection and guarantee of digital rights. Findings A total of 489 nurses answered the questionnaire. In total, 75.7% of the nurses confirmed that Euthanasia should be regulated in Spain. 66.3% indicated that information on Euthanasia should be provided jointly by doctors and nurses, and 42.3% considered that it could be applied by both medical and nursing professionals. A total of 87.2% advocated the participation of nurses in health policy, influencing the drafting of the law. In the face of possible regulation, 35% would request Conscientious Objection, being closely related to their religious beliefs. Discussion Different authors point out that nurses’ perceptions and attitudes towards Euthanasia are conditioned by different factors, such as religion, gender, poor palliative care, legality and the patient's right to die. Conclusion Nurses are positioned in favour of the regulation and practice of Euthanasia and MAS, depending on their age, years of experience, training, model of care and especially religious beliefs. (shrink)

Background: In the last decades, there have been important developments in the scientific and technological areas of healthcare. On certain occasions this provokes conflict between the patients' rights and the values of healthcare professionals which brings about, within this clinical relationship, the problem of conscientious objection. Aims: To learn the opinions that the Nurses of the Madrid Autonomous Community have regarding conscientious objection. Research design: Cross-cutting descriptive study. Participants and research context: The nurses of 9 hospitals and 12 (...) Health Centers in the Madrid Autonomous Community. The study was done by means of an auto completed anonymous questionnaire. The variables studied were social-demographical and their opinions about conscientious objections. Ethical considerations: The study was approved by the Ethical Community of Clinical Research of the University Hospital Príncipe de Asturias. Participants were assured of maximum confidentiality and anonymity. Findings: A total of 421 nurses answered the questionnaire. In total, 55.6% of the nurses confirmed they were religious believers, and 64.3% declared having poor knowledge regarding conscientious objection. The matters that caused the greatest objections were voluntary abortions, genetic embryo selection, refusal of blood transfusions, and therapy refusal. Discussion: Different authors state that the most significant cases of conscientious objections for health professionals are those regarding carrying out or assisting in abortions, euthanasia, the practice of assisted reproduction and, finally, the prescription and dispensing of the morning-after pill. In our study, the most significant cases in which the nurses would declare conscientious objections would be the refusal to accept treatment, the selection of embryos after genetic diagnosis preimplantation, the patient’s refusal to receive blood transfusions due to religious reasons and pregnant women’s request for voluntary abortions within the first 14 weeks. Conclusion: Nurses’ religious beliefs influence their opinions regarding conscientious objection. The nurses who declare themselves as religious believers object in a higher percentage than those without religious beliefs. (shrink)

Opinion leaders are informal leaders who have the ability to influence others' decisions about adopting new products, practices or ideas. In the healthcare setting, the importance of translating new research evidence into practice has led to interest in understanding how opinion leaders could be used to speed this process. Despite continued interest, gaps in understanding opinion leadership remain. Agent‐based models are computer models that have proven to be useful for representing dynamic and contextual phenomena such as opinion leadership. The purpose (...) of this paper is to describe the work conducted in preparation for the development of an agent‐based model of nursing opinion leadership. The aim of this phase of the model development project was to clarify basic assumptions about opinions, the individual attributes of opinion leaders and characteristics of the context in which they are effective. The process used to clarify these assumptions was the construction of a preliminary nursing opinion leader model, derived from philosophical theories about belief formation. (shrink)

Development of the knowledge base for a profession depends on research and scholarship that builds on the insights and work of scholars within the discipline and is disseminated through the literature. The purpose of this study was to examine a unique collection of 79 articles selected by editors as representative of their nursing journals. Articles were assessed for congruence with long‐standing values and conceptual definitions of nursing, and the extent to which they built on prior literature published in nursing. Articles (...) were scored based on whether they reflected four characteristics of nursing as a discipline (holism, social context, goal of health, and consistency with common definitions of nursing); an abstract score on the extent to which the title, abstract, or keywords indicated a general focus on nursing; and a distinction score based on whether the article distinguished nurses or nursing from other providers. Fifty of the articles received an article score of 4, indicating all four disciplinary characteristics were present in the article's content. While the majority of the articles were congruent with fundamental nursing values and perspectives, only 28% of the sources cited were from nursing sources. The lack of citations to nursing literature, coupled with an assessment that reveals gaps in substantive content that builds on nursing knowledge, raises questions about the future of nursing perspectives in the literature. (shrink)

Generally, public opinion is measured via polls or survey instruments, with a majority of responses in a particular direction taken to indicate the presence of a given ‘public opinion’. However, discursive psychological and related scholarship has shown that the ontological status of both individual opinion and public opinion is highly suspect. In the first part of this article I draw on this body of work to demonstrate that there is currently no meaningful theoretical foundation for the construct (...) of public opinion as it is typically measured in surveys, polls, or focus groups. I then argue that there is a particular sense in which the construct of public opinion does make sense. In deliberative democratic forums participants engage in dialogue with the aim of coming to collective positions on particular issues. Here I draw on examples of deliberative democratic forums conducted on the social and ethical implications of science and technology. Conversation between participants in deliberative democratic forums is ideally characterized by individuals becoming informed about the issues being discussed, respectful interactions between participants, individuals being open to changing their positions, and a convergence towards collective positions in the interest of formulating civic solutions. The end-product of deliberation on a given issue might thus be termed a deliberative public opinion. ‘Deliberative public opinion’ is neither a cognitive nor an aggregate construct, but rather a socio-historical product. Criteria for its legitimacy rely on the inclusiveness of diversity of perspectives and the degree to which collective positions are defensible to a larger society. (shrink)

BackgroundThe intensive care unit entails working as a team in rescuing patients from life-threatening conditions. The care being given by the team could also be done by nurses and other health professionals through the coordinated use of all medical practices.ObjectiveTo determine the opinion of nurses on the ethical problems they experienced while working as a team in the intensive care units of a university hospital.MethodThe descriptive research was conducted on nurses working in intensive care units (n = (...) 96). A 56-item data collection form consisting of two parts developed by the researchers was used. Frequency (percent) and median were evaluated, and statistical calculations were used for group comparisons.ResultsOut of the 82 (85.4%) nurses who participated in the study, 65 (82.3%) were university graduates. About 52 (66.7%) of the participants were female with a mean age of 28.12 ± 5.84; 26 (31.6%) had intensive care certification, and 54 (65.1%) had ethical training. The internal intensive care unit nurses were less satisfied with their jobs, able to use tools, said that they had the right to refuse the patient compared to the surgical intensive care unit nurses. Discussion and conclusions: It is a positive situation for the participants to score low with ethical problems based on suggestion as the probability of meeting with their teammates. However, it is important that the problems that affect the motivation of the nurses are different according to the intensive care unit and the employees. (shrink)

The public image of nursing is important because it can facilitate or create barriers to achieving an adequate supply of nursing human resources. This study sought to gain a better understanding of nursing’s professional image within the Republic of Georgia. The Nursing Human Resources Systems model was used to guide the study’s exploratory, qualitative approach. Data collection occurred over a 2‐week period in the Republic of Georgia, and thirty‐three participants formed the final study sample. Participants included healthcare professionals, key (...) informants from nonprofit and research institutions, and patients. Data analysis occurred using directed content analysis techniques, and three themes emerged: (a) gender dimension; (b) the nursing service recipient experience; and (c) historical legacies. Themes revealed the complexities of nursing’s image in the country. Findings from this study serve as baseline data for understanding nursing’s image in the Republic of Georgia which could assist with improving pre‐entry nursing production issues. (shrink)

The quasi-ubiquity of ICT is transforming contemporary politics and seems to deteriorate democracy, for the technologies undermine debates, contest the grounds of reason and truth, and influence people’s votes. Donald Trump’s election and Brexit are good examples of their effects on public opinion. More fundamentally, these technologies cause theoretical problems to the way we traditionally conceive public opinion. Thus, I seek to rethink public opinion beyond conventional approaches. Departing from Deleuze and Guattari’s work, I develop the first (...) steps of a post-representational theory of public opinion as a regime of political truths that has new dimensions of truth production with information and communications technologies. (shrink)

The purpose of this study was to determine the opinions and expectations of patients and nurses about privacy during a hospital admission for surgery. The study explored what enables and maintains privacy from the perspective of Turkish surgical patients and nurses. The study included 102 adult patients having surgery and 47 nurses caring for them. Data were collected via semistructured questionnaire by face-to-face interviews. The results showed that patients were mostly satisfied by the respect shown to their (...) privacy by the nurses but were less confident of the confidentiality of their personal data. It was found that patients have expectations regarding nursing approaches and attitudes about acknowledging and respecting patient autonomy and confidentiality. It is remarkable that while nurses focused on the physical dimension of privacy, patients focused on informational and psychosocial dimensions of privacy, as well as its physical dimension. (shrink)

Abstract Building on Philip Converse's understanding of public opinion, John Zaller sees the evidence for the public's ?nonattitudes? as reflecting individuals? ambivalence concerning political issues. Because neither individuals nor the public collectively have what Zaller would call real attitudes, he concludes that the effectiveness of democracy rests on competition among intellectual and political elites. In truth, however, the public has many real attitudes that depend heavily on elite leadership, in ways that Converse did not initially emphasize (...) but that are consistent with both his observations and Zaller's model of mass opinion. The quality of the public's attitudes are, however, a point of serious contention. (shrink)

Background Dignity is a central human value supported by nurses’ professional ethics. In previous studies, nurses in clinical practice have experienced that dignity increased their work well-being and pride of work. Dignity is also strictly interweaved to professional identity in the different nursing’ roles, but little is known about dignity among public health nurses and primary care settings. Purpose This study aimed to describe the perceptions of nursing's professional dignity of public health nurses in (...) primary care in Finland. Research design An inductive qualitative descriptive approach with semi-structured focus group interviews was utilised. Participants and research context Twenty-seven Finnish public health nurses were interviewed via eight semi-structured focus group interviews in primary health care settings. Ethical considerations Before data collection, research permissions were obtained from participating health care centres. This type of research in Finland, with competent adult participants, does not require ethical pre-assessment but written and oral informed consent obtained before the interviews. Findings Based on our findings, public health nurses perceived that professional dignity was (1) part of their self-respect, an observed daily value based on their acknowledged competence. Besides, they perceived that (2) service users’ trust in public health nurses was a strong expression of professional dignity, and it could be uncovered when recipients of care utilised their services. In addition, public health nurses experienced that (3) professional dignity was an expression of different intertwined interprofessional and social factors. Discussion and conclusion Professional dignity is simultaneously an essential prerequisite and an outcome of public health nurses’ work. In future, more information would be needed to implement strategies in primary health care to foster nurses’ professional dignity also in international public health arenas. (shrink)

(1996). Public opinion and democratic culture: The French revolution. The European Legacy: Vol. 1, Fourth International Conference of the International Society for the study of European Ideas, pp. 175-180.

(1996). Public opinion and democratic culture: The French revolution. The European Legacy: Vol. 1, Fourth International Conference of the International Society for the study of European Ideas, pp. 175-180.

ABSTRACT George Bishop’s The Illusion of Public Opinion does a superb job of showing how various errors and malfeasances in conducting and interpreting surveys have created illusions about public opinion. It thereby offers a very useful compendium on how to do, and especially how not to do, survey research. Nothing in the book, however, provides persuasive evidence for either of two more troubling “illusion” arguments: that collective public preferences on policy issues do not exist; or that surveys (...) cannot measure them. Instead, Bishop’s examples show that even in obscure, low‐information situations, well‐designed survey questions generally reveal meaningful collective policy preferences that are coherent, well differentiated, and reflective of citizens’ basic interests and values. (shrink)

Public health nurses (PHN) have had a long history of working with new mothers in the community. Their practice includes collaboration, building therapeutic relationships, mutual goal setting, establishing trust, supporting clients’ strengths, empowerment and social justice. The wealth of information that new mothers receive both solicited and unsolicited may come from many different sources such as medicine, midwifery and those created personally by families. Although much of the information on mothering is presented with the intent of helping, it (...) can also be hegemonic and oppressive depending on different discourses, stereotypes and myths of mothering and therefore may cause confusion, guilt and uncertainty. Public health nurses often address conflicting social, cultural and personal discourses about mothering practices in order to support an empowering mothering experience. The term ‘social mediator’ was purposefully created in an attempt to describe the unique work of PHNs that this author has witnessed through her own research and practice as a PHN. This paper will present a discussion of the author's own work and research findings that will suggest how feminist poststructuralist theory may be used to guide and understand information exchange between PHNs and mothers as they mediate different social, cultural and personal discourses on mothering. (shrink)

Anticipatory policy for gene editing requires assessing public opinion about this new technology. Although previous surveys have examined respondents’ views on the moral acceptability of various hypothetical uses of CRISPR, they have not considered whether these scenarios are perceived as plausible. Research in construal level theory indicates that participants make different moral judgments about scenarios seen as likely or near and those seen as unlikely or distant. Therefore, we surveyed a representative sample of 400 Americans and Canadians about both (...) the likelihood and the permissibility of 23 commonly discussed uses of gene editing. Respondents with more knowledge of gene editing generally thought these applications would be more likely within the next 20 years. There was a strong positive relationship between the perceived likelihood and permissibility of most CRISPR applications. Our results suggest that ongoing public engagement efforts for gene editing could be improved by taking its perceived time-frames into account. (shrink)

This paper considers the relation between philosophical discussions of, and social-scientific research into popular beliefs about, distributive justice. The first part sets out the differences and tensions between the two perspectives, identifying considerations which tend to lead adherents of each discipline to regard the other as irrelevant to its concerns. The second discusses four reasons why social scientists might benefit from philosophy: problems in identifying inconsistency, the fact that non-justice considerations might underlie distributive judgments, the way in which different principles (...) of justice can yield the same concrete distributive judgments, and the ambiguity of key terms. The third part distinguishes and evaluates three versions of the claim that normative theorising about justice can profit from empirical research into public opinion: that its findings are food for thought, that they amount to feasibility constraints, and that they are constitutive of normatively justified principles of justice. The view that popular opinion about justice has a strongly constitutive role to play in justifying principles of distributive justice stricto sensu is rejected, but it is argued that what the people think (and what they can reasonably be expected to come to think) on distributive matters can be an important factor for the political theorist to take into account, for reasons of legitimacy, or feasibility, or both. (shrink)

This article draws attention to the nature and importance of public policy. It argues that if nurses are to influence the quality of healthcare effectively, they must be engaged with policymakers to get nursing care issues on the policy agenda. There is an ethical imperative to do so, driven by the advocacy role of the nurse and rooted in the values base of nursing. In addition, it is argued that if one takes the role of patient advocacy seriously, (...) as core to the nursing role, two things are required of nurses: We must (a) broaden the conceptualisation of patient advocacy beyond the individual patient to the system of healthcare resourcing and provision and (b) see systemic change as important as change at the bedside. (shrink)

ABSTRACT Benjamin Page's thoughtful critique of my book, The Illusion of Public Opinion, strives to reassure readers that all is well—despite the book's extensive documentation of measurement‐error artifacts in numerous public opinion surveys. Page's own careful polling practices are not followed outside of elite academic survey centers. Moreover, even in such well‐run surveys, the respondents are often ignorant of the issues being probed. The fact that nonrandom reasons of some sort must be determining on‐the‐spot survey responses may allow (...) us to call the respondents “rational” in a loose sense. But the responses still don't represent actual opinions about the specific policy issues being probed—let alone well‐informed answers. Finally, while Page argues that measurement errors are most likely random, and should cancel out in the aggregate, the “miracle of aggregation” doesn't occur when the form, wording, and context of questions varies from survey to survey. And even when wording and context are held constant, the respondents' understanding of the same words can vary dramatically or subtly over time, due to new political events and their changing interpretation. (shrink)

This major work surveys the historical roots, theoretical foundations, and normative claims of 20th-century conceptualizations of public opinion. It reanalyzes leading traditions, such as those of Lippmann, Dewey, and Noelle-Neumann, and reinvents some unjustly ignored ones, such as Toennies, Harrisson, and Wilson. The book critically examines popular modern research strategies such as polling and the 'spiral of silence' model and looks at the role of mass media in the formation and expression of public opinion.

Using a recent example from US politics as representative of contemporary liberal democracies, this chapter highlights how public opinion is shaped through the exploitation of our epistemic interdependence and partisan bias. Climate change was an important issue leading into the 2010 US mid-term elections. Public opinion on climate change was subject to a number of willfully disseminated distorting influences, having a significant impact on the election’s outcome and subsequent political discourse surrounding climate change policies. One impact of this (...) type of exploitation is that it has epistemically compromising effects on the electorate, which in turn undermines democratic legitimacy. In the interest of defending democratic legitimacy, this chapter suggests we re-evaluate and update those liberal institutions necessary for informed public opinion surrounding our current political epistemic needs. (shrink)

The aim of this study was to evaluate agreement between nurses’ and physicians’ opinions regarding aggressiveness of treatment and to investigate and compare the rationales on which their opinions were based. Structured interviews regarding 714 patients were performed on seven general wards of a university hospital. The data gathered were then subjected to qualitative and quantitative analyses. There was 86% agreement between nurses’ and physicians’ opinions regarding full or limited treatment when the answers given as ‘uncertain’ were excluded. (...) Agreement was less (77%) for patients with a life expectancy of less than one year. Disagreements were not associated with professional status because the physicians considered limiting life-sustaining treatment as often as the nurses. A broad spectrum of rationales was given but the results focus mostly on those for full treatment. The nurses and the physicians had similar bases for their opinions. For the majority of the patients, medical rationales were used, but age and quality of life were also expressed as important determinants. When considering full treatment, nurses used quality-of-life rationales for significantly more patients than the physicians. Respect for patients’ wishes had a minor influence. (shrink)

By analysing the first, second, 10th and 11th years of publication (i.e. volumes 1, 2, 10, 11) of Nursing Ethics, I will show the significant visible trends in the articles and draw some conclusions. The trends are visible at various levels: from simple analysis of an issue, or a comment on a situation in the early years, to in-depth philosophical and research studies; and from short statements to much longer articles. The ethical approaches used go from either none or unquestioned (...) assumptions to several approaches used in any one study. This corresponds to the general postmodern trend in society. The interpretation made of these trends is of a kind of protest at nurses and nursing being devalued. Although this is expressed negatively, the positive message conveyed is that nurses are now taking their professional life into their own hands, vigorously and more daringly than a decade ago. (shrink)

How should political theorists go about their work if they are democrats? Given their democratic commitments, should they develop theories that are responsive to the views and concerns of their fellow citizens at large? Is there a balance to be struck, within political theory, between truth seeking and democratic responsiveness? The article addresses this question about the relationship between political theory, public opinion and democracy. I criticize the way in which some political theorists have appealed to the value of (...) democratic legitimacy in an attempt to justify a more opinion-sensitive approach to their work. Specifically, I identify a problematic model in the existing literature, which I term ‘democratic restraint’: an approach on which the theorist moderates her normative principles in response to evidence about public attitudes in order to enhance the legitimacy of her account. This model renders the discipline newly vulnerable to an otherwise misguided objection that political theory seeks to pre-empt democratic politics. I trace the problem with the democratic restraint model to its flawed underlying conception of democratic legitimacy. The article then outlines a more appealing ‘democratic underlabourer’ view of the status of political theory and draws out the implications of this alternative account for the role of public opinion. (shrink)

To understand the prospects for global order and progress in the coming years, we explore the joint implications of three premises: (1) states advantaged by the current international order have stakes in its regularity and predictability, and thus in moving to counter or prevent threats to those stakes; (2) along impure public and club goods lines, they are more likely to make efforts to do so when some private or club benefits result; and (3) public opinion provides a (...) bounded policy acceptance envelope offering incentives and disincentives to national political elites to act as envisioned by the first two premises. We present a mosaic of public opinion in major OECD countries (the US, Japan, and major EU members) on three policy areas that contain international public goods elements. Actual contribution tendencies in those areas found in our previous work largely conform to the public opinion patterns reported here. Within the limits of available data, domestic political incentives as represented by public opinion warrant neither extreme optimism nor pessimism about the prospects for continuing contributions by OECD states to sustaining orderly functioning of the current world system. (shrink)

In 1992, Bill Clinton won the presidency committed to an ambitious program of “public investment.” Yet the plan Clinton submitted to the Democrat-controlled Congress in early 1993 was sharply scaled back in favor of an emphasis on reducing the federal budget deficit. Congress then made further deep cuts in Clinton's plan. This Democratic retreat from public investment would continue throughout the remainder of Clinton's presidency. In this article, I argue that the fate of “Clintonomics” was due mainly to (...) public opinion and electoral politics. In an epilogue, I examine the implications of this episode for the new intra-Democratic debate over public investment. (shrink)

Before expressing opinions, most people usually consider the standpoint of their friends nearby to avoid being isolated, which may lead to the herding effect. The words of celebrities in social networks usually attract public attention and affect the opinion evolution in the entire network. This process also causes the similar status quo. In this study, we find that the key figures play the guiding roles in public opinions who undertake the group pressure from information amount. Therefore, we build (...) the cost function on opinion changes to study opinion evolution rules for public persons based on the spreading scope of information and information amount. Simulation analysis reveals that the information amount held by agents will affect the converging speed of public opinions, while enhancing the ability of key nodes may no more effective in guiding public opinion. (shrink)

The rapid development of Internet technology has facilitated the dissemination of information that can threaten national security and public health, and effectively controlling the process of public opinion communication is an important topic in contemporary social network research. This paper establishes an official information-controlled public opinion propagation model based on the delay, latency, and conversion of public opinion communication under the control of official information. According to the influence and importance of the network nodes, we theoretically (...) derive the attitude conversion probability of the nodes, making the model more in line with the actual situation. Through actual cases, we analyzed the important influence of official information on the public opinion communication process and provided a theoretical basis for the government and relevant departments to supervise and correctly guide the public opinion network, which has certain practical significance. (shrink)

Conscientious objection to participating in induced abortion is not present in the Finnish health care system or legislation unlike in many other European countries.

Background: Hospital nurses are frequently the first care givers to receive a patient’s request for euthanasia or physician-assisted suicide (PAS). In France, there is no consensus over which medical practices should be considered euthanasia, and this lack of consensus blurred the debate about euthanasia and PAS legalisation. This study aimed to investigate French hospital nurses’ opinions towards both legalisations, including personal conceptions of euthanasia and working conditions and organisation. Methods: A phone survey conducted among a random national sample (...) of 1502 French hospital nurses. We studied factors associated with opinions towards euthanasia and PAS, including contextual factors related to hospital units with random-effects logistic models. Results: Overall, 48% of nurses supported legalisation of euthanasia and 29%, of PAS. Religiosity, training in pallative care/pain management and feeling competent in end-of-life care were negatively correlated with support for legalisation of both euthanasia and PAS, while nurses working at night were more prone to support legalisation of both. The support for legalisation of euthanasia and PAS was also weaker in pain treatment/palliative care and intensive care units, and it was stronger in units not benefiting from interventions of charity/religious workers and in units with more nurses. Conclusions: Many French hospital nurses uphold the legalisation of euthanasia and PAS, but these nurses may be the least likely to perform what proponents of legalisation call “good” euthanasia. Improving professional knowledge of palliative care could improve the management of end-of-life situations and help to clarify the debate over euthanasia. (shrink)