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Death With Dignity Act, end-of-life care, nurses' knowledge, physician-assisted death, physician-assisted suicide



  1. Clymin, Janine MSN, ARNP, GNP-BC
  2. Jacobson, Dana MSN, ARNP, GNP-BC
  3. Jablonski, Anita PhD, RN, CNE
  4. Feldt, Karen S. PhD, ARNP, GNP-BC


The Washington state Death With Dignity Act of 2009 allows competent, terminally ill adults to request a lethal dose of medication from a physician. The purpose of this qualitative study was to evaluate nurses' knowledge and personal views on the newly enacted law through 516 comments made by surveyed nurses. Main themes that emerged were lack of knowledge about the Death With Dignity Act itself and facility policy on the Act. Nurses have strong feelings in favor of and in opposition to the law often with a clear expression of conflict related to personal beliefs, the Nursing Code of Ethics, and facility policy. Most nurses would refer a patient to another source if asked about the Death With Dignity Act. Gaps in knowledge about the Act contribute to fear of job loss and other ethical conflicts associated with responding to patients who may inquire about the law. A potential barrier exists with regard to nurses providing patients with accurate information about the law. Nurses need more education and clear-cut guidelines on the Death With Dignity Act to better support them, as they are likely to be faced with patient inquiries.