Danielle Blondeau

Factors explaining the intention to give blood among the general population

Background and Objectives  The aim of this study was to identify factors explaining the intention to donate blood.

The Attitude of Canadian Nurses Towards Advance Directives

This article seeks to shed light on the beliefs that influence nurses’ intention of respecting or not respecting an advance directive document, namely a living will or a durable power of attorney. Nurses’ beliefs were measured using a 44-statement questionnaire. The sample was made up of 306 nurses working either in a long-term care centre or in a hospital centre offering general and specialized care in the province of Québec. The results indicate that nurses have a strong intention of complying with advance directives written by patients. The analysis also shows that four variables determine the strength of this intention: respect for autonomy; the location of the workplace; justice; and the dimension of relationships and emotions. Although these documents favour the expression of patients’ wishes, nurses should be aware that they do not systematically guarantee respect of a patient’s autonomy, nor do they replace a relationship based on trust between patients and health care professionals.

The dying person: An existential being until the end of life

This article explores the experience of death from the perspective of existential philosophy, for the purpose of finding ways to humanize end-of-life nursing care. A person in his or her final days is seen by the caregiver as a being seeking the continual creation of his human becoming, from the experience of sickness to death. From the moment the torment of suffering begins, a person needs a presence of humanistic professionalism that embraces the values of the nursing profession.

La différence: condition of exclusion or of reconnaissance?

From the Middle Ages onto the 19th century, following the trend set in leper hospitals, madness was to be hidden, secluded in dark places, far away from the mainstream of society. The emergence of the mad person, perceived as inevitably different, allows to make the boundaries between reason and folly, between human and inhuman, irrelevant. If leper hospitals have almost emptied out, if there are much fewer confinement facilities, the values and images related to the leper or the mad person, as well as the sense of exclusion, continue to persist. The purpose of this paper is to show clearly that this matter of exclusion is a serious legacy that could very well apply nowadays to other figures that, each in their own way, symbolize menace or mockery. It applies notably to the aged and the dying who both appear as the opposite of modern society and its values of efficiency, productivity and profitability. The multiplication of places where old people are left to die, and the elderly who are crowded in old folks homes, stand as proof of their exclusion from society. Nevertheless, youth and old age coexist, as well as life and death. If care of others is the trait of a humane civilization, must it be understood that barbarism consists in ignoring its own humanity as well as that of others? In view of such practices of exclusion, policy statements based on recognition of human dignity, where ethical obligation rests on recognition of others and humanism, are rather paradoxical. Is this a paradox or a deadlock; a condition of exclusion or of reconnaissance?

Psychosocial determinants of physicians’ intention to practice euthanasia in palliative care

BackgroundEuthanasia remains controversial in Canada and an issue of debate among physicians. Most studies have explored the opinion of health professionals regarding its legalization, but have not investigated their intentions when faced with performing euthanasia. These studies are also considered atheoretical. The purposes of the present study were to fill this gap in the literature by identifying the psychosocial determinants of physicians’ intention to practice euthanasia in palliative care and verifying whether respecting the patient’s autonomy is important for physicians.MethodsA validated anonymous questionnaire based on an extended version of the Theory of Planned Behavior was mailed to a random sample of 445 physicians from the province of Quebec, Canada.ResultsThe response rate was 38.3% and the mean score for intention was 3.94 ± 2.17 (range: 1 to 7). The determinants of intention among physicians were: knowing patients’ wishes (OR = 10.77; 95%CI: 1.33-86.88), perceived behavioral control—physicians’ evaluation of their ability to adopt a given behavior—(OR = 4.35; 95%CI: 1.44-13.15), moral norm—the appropriateness of adopting a given behavior according to one’s personal and moral values—(OR = 3.22; 95%CI: 1.29-8.00) and cognitive attitude—factual consequences of the adoption of a given behavior—(OR = 3.16; 95%CI: 1.20-8.35). This model correctly classified 98.8% of physicians. Specific beliefs that might discriminate physicians according to their level of intention were also identified. For instance, physicians’ moral norm was related to the ethical principle of beneficence.ConclusionsOverall, physicians have weak intentions to practice euthanasia in palliative care. Nevertheless, respecting patients’ final wishes concerning euthanasia seems to be of particular importance to them and greatly affects their motivation to perform euthanasia.

Psychosocial determinants of nurses’ intention to practise euthanasia in palliative care

Background: Most studies on euthanasia fail to explain the intentions of health professionals when faced with performing euthanasia and are atheoretical. Research objective: The purpose of this study was to identify the psychosocial determinants of nurses’ intention to practise euthanasia in palliative care if it were legalised. Research design: A cross-sectional study using a validated anonymous questionnaire based on an extended version of the Theory of Planned Behaviour. Participants and research context: A random sample of 445 nurses from the province of Quebec, Canada, was selected for participation in the study. Ethical considerations: The study was reviewed and approved by the Ethics Committee of the Centre hospitalier universitaire de Québec. Findings: The response rate was 44.2% and the mean score for intention was 4.61 ± 1.90 (range: 1–7). The determinants of intention were the subjective (odds ratio = 3.08; 95% confidence interval: 1.50–6.35) and moral (odds ratio = 2.95; 95% confidence interval: 1.58–5.49) norms. Specific beliefs which could discriminate nurses according to their level of intention were identified. Discussion: Overall, nurses have a slightly positive intention to practise euthanasia. Their family approval seems particularly important and also the approval of their medical colleagues. Nurses’ moral norm was related to beneficence, an ethical principle. Conclusion: To our knowledge, this is the first study to identify nurses’ motivations to practise euthanasia in palliative care using a validated psychosocial theory. It also has the distinction of identifying the ethical principles underlying nurses’ moral norm and intention.