Navigating end-of-life care dilemmas: a qualitative inquiry of nurses' and midwives' knowledge of euthanasia and circumstantial factors influencing euthanasia in a resource-constraint setting.

Background: Deaths can be caused by terminal illnesses, accidents, or natural disasters. However, medically, death can be hastened by healthcare providers, patients themselves, or their relatives. In advanced cancers where the patient's quality of life is compromised, Euthanasia can be used to hasten death. Inadequate medical resources and low socioeconomic status have been cited as factors influencing Euthanasia. This study sought to explore nurses' and midwives' knowledge and perspectives on Euthanasia in resource-constrained health facilities.

Methods: A qualitative exploratory, descriptive design was used to recruit 24 nurses and midwives from three major referral hospitals, two regional hospitals, and one district hospital. Data was collected through individual in-depth face-to-face and telephone interviews. Braun and Clarke's (2006) thematic data analysis approach was used.

Findings: Three main themes and eight subthemes were generated from the data: the main themes include Knowledge of Euthanasia, health system resource constraint-driven euthanasia and family resource constraint-motivated euthanasia. The findings indicate that nurses and midwives lack understanding of some terminologies related to the act. Strict policy decisions, inadequate resources, and misunderstanding of palliative care resulted in the practice of Euthanasia. Additionally, unbearable pains and financial constraints of families of critically ill patients made them request Euthanasia in the health facilities.

Conclusion: The study highlights the challenges of end-of-life care in resource-constrained settings, emphasizing the need for provider training, increased healthcare capacity, and clearer national guidelines for ethical decision-making.