Unreported Intentional Life-Ending Acts in Physicians and Nurses

Introduction Intentional life-ending acts (LA) includingeuthanasia and termination of life without explicit request are illegal in Germany and have not been extensively studied. In a pilot study, unreported LA administered by physicians and nurses in German health care were explored. Methods All hospitals and nursing homes registered in 2015 (n = 13 393) were contacted via mail or e-mail and physician and nursing staff were asked to complete an anonymous online-survey or the identical attached paper-pencil questionnaire. 4629 participants, including physicians (n = 356), nurses (n = 3121) und geriatric nurses (n = 1152) from a predominant in-patient working area responded to questions about LA at their workplace, requests for euthanasia and performance of LA. Results 2.25 - 4.01 % (172 participants) of all physicians and nurses indicated to have heard of euthanasia at their workplace in the last 12 months and 1.42 - 3.39 % (77 participants) indicated to have performed LA themselves. LA was more frequently administered by male participants, physicians and on intensive care units. More than one third of all participants who had administered LA (38.10 - 41.67 %) were never asked for it. Discussion This pilot study indicates that beside legal forms of passive and indirect euthanasia, illegal intentional life-ending acts are administered by physicians and nurses in all health-care areas under investigation.