PERCEPTION ON EUTHANASIA OF NURSING STUDENTS OF FILAMER CHRISTIAN

UNIVERSITY

A Thesis Presented to

Mr. Leo Art Borres

Filamer Christian University

Roxas City

In Partial Fulfillment of the

Requirements for Final Exam

By:

Aldea, Erica A.
Cipe, Emereen V.
Ciudadano, Jannie Lois B.
Facinal, Shulamite B.
Gelilang, Danica Liz B.
Idaniol, Denize Ann A.
Merisco, Trisha Ann R.
Perception on Euthanasia of Nursing Students of Filamer Christian

University

Chapter 1

Introduction

Chapter 1 is made up of five parts, namely: (1) Background

and Theoretical Framework of the Study, (2) Statement of the

Problem and the Hypothesis, (3) Significance of the Study, (4)

Definition of Terms, and (5) Delimitation of the Study.

Part One, Background and Theoretical Framework of the Study,

presents the introduction, discusses the rationale for conducting

the investigation and presents the theoretical framework, which

serves as the study’s frame of references.

Part Two, Statement of the Problem and the Hypothesis, gives

the main problem and the specific questions the study seeks for

an answer. It also presents the hypothesis to be tested.

 Part Three, Significance of the Study, provides explanation

on what benefit each stakeholder will have on the research

results.

Part Four, Definition of Terms, gives the meaning of the

important terms used in the study conceptually and operationally.

Part Five, Delimitation of the Study, sets the scope of the

research in terms of research design, participants, sample size

and sampling procedures, locale, data-gathering instruments, and

statistical tools employed in the analysis of data.

Background of the Study

Euthanasia or mercy killing arises from its roots on

Homerian epics with the meaning of a good or painless death

(Parpa E, Mystakidou K, Tsilika E, 2008). The intention to

deliberately accelerate the death of an incurable patient, even

to stop his suffering, has never been unambiguous. More and more

people think that euthanasia is much more humane in some cases

than life (Piccirilli Dorsey, Inc., 2017). Nevertheless, it is

necessary to find out whether people have the right to decide if

someone needs to die or to live further. This question is of

interest to both ordinary people and doctors. What is more, it is

unlikely that humanity will come to a single denominator in this

matter. That is why there are arguments for and against

euthanasia (EssayShark, 2017).

In the Philippines, euthanasia has not been legalized due to

reasons of religious beliefs of the communities which the

accreditation of the Euthanasia Bill had been hampered

(Jirocadungon, 2013). Debating on the justification of the

euthanasia is a complex issue and involves legal, religious and

cultural implications (Pereira J., 2011). Books on Jurisprudence

mention it sparingly without coating any legal authority.

Guidelines, personal views, and opinions on when to withhold or

withdraw treatment or life-supporting systems, and who should

have a say in such decisions, are provided in an abundance of

papers (Tinne Smets M, Joachim Cohen, PhD, 2011).

There is a dearth of published discourse on healthcare

ethics in Pakistan. Values that are considered to stem from

religious teachings predominate in discussions relating to

medical ethics. A lack of effective policy and legislation

concerning the ethical practice of medicine is reported to have

negative effects on the profession. Consideration of ethical

issues in health is at an early stage in the country and may

reflect the situation in a large part of the developing world

(UKessays, 2013).

Euthanasia makes it possible to fully exercise the human

right to dispose of their lives, including making decisions on

the termination of their own lives. Secondly, a person is

recognized as the highest value, and consequently, her/his real

well-being, the needs and the right to self-determination, the

right to freedom, the right to respect for dignity, the right to

dignity must be guaranteed and fully guaranteed (Strinic, Visnja,

2017). Thirdly, euthanasia provides the implementation of one of

the fundamental principles of law, the principle of humanism.

Euthanasia is humane because it stops the suffering and torment

of an incurably sick person. The state and society must recognize

this right not for everyone, but for the sake of the small group

of people who need it (Strinic, Visnja, 2017).

It is also worth noting the point of view of the European

Court of Human Rights, which maintains a neutral position on this

issue, recognizing the right of the States Parties to autonomy in

settlement of euthanasia (“The Right To Assisted Suicide In The

Case Law Of The European Court Of Human Rights”, 2014). Analyzing

their decisions about euthanasia, it can be seen that, in most

cases, the court did not take into account the material aspect of

the cases, but resolved them on the basis of violations of the

procedural form. However, it should be recalled that, in fact, in

all civilized countries, a murder of compassion persists in

practice regardless of whether it is permitted by law or not. The

literature indicates that 40% of all deaths of sick people occur

as a result of medical decisions made by the physicians about the

cessation of life either by refusing treatment or by drugs that

accelerate its onset (Essayshark, 2017).

A current study had been conducted and it represents the

first quantitative investigation of the psychological

ramifications of euthanasia‐related work. Results indicate that

perceived euthanasia‐related strain is prevalent among shelter

employees and is associated with increased levels of general job

stress, work‐to‐family conflict, somatic complaints, and

substance use; and with lower levels of job satisfaction.

Analyses provide evidence that euthanasia‐related work has a

significant negative relation with employee well‐being

independent of its relation with generalized job stress.

Exploratory analyses also suggest that individual, work, and

organizational differences may influence the level of perceived

stress and appear to be associated with certain aspects of

employee well‐being. The need for future research of this topic

and its relevance to a wide range of applied psychologists is

discussed (Steven, Rogelberg, Spitzmüller, Digiacomo, 2007)

 Another interventional study was undertaken to assess the

impact of physiotherapy education on the knowledge and attitudes

of physiotherapists (PTs) and physiotherapy students (PSs) toward

euthanasia. The findings of the current study suggest that the

attitudes of PTs are different from those of PSs, and the Islamic

point of view has a negative impact on the attitudes of PTs and

PSs toward euthanasia (Cavlak, Bas Aslan, 2007)

Theoretical Framework

Kant’s
Morals and Profile: Perceptions
Theory
Ethics Sex On
and
of Age Euthanasia
Mills’
People Religion
Theory
Civil Status
Monthly
Allowance

Figure 1. Left to right. Theories; Simple explanation

relating and affecting to the theories and the independent

variable; Independent variable; Dependent variable

This study is anchored to the moral theory of Immanuel Kant.

He is generally credited with much of the foundational thought in

the evolution of deontology and deontological perspectives. Kant

viewed the ability of human beings to reason as the basis of our

status as moral agents. His ethical theory has been very

influential. In his The Foundations of the Metaphysics of Morals,

he presents an account of moral duty. For an action to have moral

worth, for it to reflect a good will, the action must be

undertaken for duty’s sake- and not for some other reason, such

as fear of being caught or punished. Kant is not happy with all

of these ideas that euthanasia should be legalized or encouraged

no matter the situation. This kind of maxim will not form a

universal law; since it cannot form a universal law, then it

should be removed and replaced with a more reasonable maxim. If

we will such maxim, we will end in hypothetical imperative not

categorical. We must thus act in ways that do not disrespect our

fellow human beings and ourselves. It will be disastrous if we

act in such way as dehumanizing ourselves through euthanasia.

This is the point that Kant wants us to understand. (Odianosen,

Academia, 2018)

Another theory is from John Stuart Mills. His ethical theory

mainly talks about pleasure and avoidance of pain. According to

him, "actions are right in proportion as they tend to promote

happiness, wrong as they tend to produce reverse of happiness".

Hence voluntary active euthanasia can produce happiness for a

number of people. Firstly the persons suffering from pain will

get rid of it and having control over their lives would give

pleasure. Secondly the family of the patients, who feel the pain
of their close ones, and who are spending lots of money in the

treatment, will ultimately be free of pain. Therefore

utilitarian's would allow active voluntary euthanasia because it

follows greatest happiness principle (UKessays, 2013)

Morals and ethics are also being influenced by our sex, age,

and religion. Implicating these two theories in this study,

morals and ethics can influence the perceptions of people on

Euthanasia.

Their variables and respective relationships being

considered in the study is shown in the succeeding figure 1.

Independent Variable Dependent Variable

Profile of Nursing
Students in terms of: Perception
Sex On
Age Euthanasia
Religion
Civil Status
Monthly Allowance

Figure 2. Independent Variable – Profile of Nursing Students;

Dependent Variable – Perception on Euthanasia

 Statement of the Problem and Hypothesis

The study aims to determine the perceptions on Euthanasia of

Nursing students of Filamer Christian University for academic

year 2018-2019.

Specifically, the study sought to answer the following:

1. What is the perception on Euthanasia of Nursing students as

an entire group and classified into socio-demographic

factors such as sex, age, religion, civil status and monthly

allowance?
2. Is there a significant difference on the perception on

Euthanasia of Nursing students as an entire group and

classified into socio-demographic factors such as sex, age,

religion, civil status and monthly allowance?

In view of the aforementioned problems, the following is

hypothesized:

1. There is no significant difference in the level of

perception in Euthanasia of Nursing students as an entire

group and classified into socio-demographic factors such as

sex, age, religion, civil status and monthly allowance.

 Significance of the Study

This study can generate information about the students’

perception of Euthanasia which may be beneficial to the

following:

Students. The findings of the study can give the students

the ideas of the general characteristics of students as far as

perception of Euthanasia.

Teachers. The teachers will be aware of the nursing

students’ perception to euthanasia. In discussing euthanasia to

nursing students, the teachers need to gear and develop new

teaching strategies in teaching in accordance to euthanasia.

Parents. The findings of the study can give the parents the

idea on how their children perceive euthanasia and their

understanding of euthanasia.

School Administrators. The results of the study will be

useful to the school administrators because it will present to

them the interpretation of the perception of the students on

euthanasia. This study may be used by school administrators in

the implementations of programs and seminars regarding to

euthanasia.
 Religious Administrators. The results of the study can give

the religious administrators the idea on what is the perception

of nursing students to euthanasia. This study can give the

religious administrators the understanding and knowledge about

euthanasia.

Health Practitioners. The findings of the study can give the

health practitioners the idea on what is the impression of the

nursing students towards euthanasia.

Future Researchers. The results of the study can serve as

baseline for the future researchers who may want to conduct

further studies on the perception of euthanasia.

Definition of Terms

For clearer understanding of this study, some terms were

defined conceptually and operationally as follows:

Perception- refers the act or faculty of perceiving, or

apprehending by means of the senses or of the mind; cognition;

understanding (Merriam Webster, 2018).

 In this study, this refers to the scores that will be

obtained by the students in the Perception on Euthanasia

Questionnaire which will be an adapted and modified

Questionnaire. This questionnaire will focus on perception in

Euthanasia and Profile of Nursing students which includes age,

gender and religion. The responses are scored as: strongly agree-

5, agree-4, uncertain-3, disagree-2 and strongly disagree-1. The

perception about Euthanasia are arbitrarily categorized as very

high (4.21-5.00), high (3.41-4.20), moderately high (2.61-3.40),

low (1.81-2.60), and very low (1.00-1.80).

Euthanasia- also called mercy killing. the act of putting to

death painlessly or allowing to die, as by withholding extreme

medical measures, a person or animal suffering from an incurable,

especially a painful, disease or condition (Dictionary, 2018).

In this study, it is the focus and the one being studied for

us to determine the nursing students’ perception.

Sex- The differences between male and female sexes are

anatomical and physiological. It tends to relate to biological

differences (Newman, 2018).

In this study, this refers to the gender of respondents. It

can be describe as male and female.

 Age- It is the interval of time between the day, month and

year of birth and the day and year of occurrence of the event

expressed in the largest completed unit of solar time such as

years for adults and children and months, weeks, days, hours or

minutes of life, as appropriate, for infants under one year of

age (Handbook of Vital Statistics Systems and Methods, 2006).

In this study, this refers to the years of existence of the

Nursing Students. The choices may include 20-below and 21-above.

Religion- It is the fundamental set of beliefs and practices

generally agreed upon by a group of people. These set of beliefs

concern the cause, nature, and purpose of the universe, and

involve devotional and ritual observances. They also often

contain a moral code governing the conduct of human affairs

(AllAboutGOD, 2018).

In this study, this refers to the religious beliefs of the

Nursing Students. The choices may include Roman Catholic,

Baptist, Muslim, None and others.

Civil Status- It can mean being single, married, in a civil

union, adopted, divorced, a member of a single-parent family, or

any form of family ties or affinity with another person

(Commission des droits de la personne et des droits de la

jeunesse, 2018).
 In this study, this refers to the status of the Nursing

Students whether they are single or married.

Monthly Allowance- It is a monthly salary or monthly wage

(Sensagent, 2012).

In this study, this refers to the Nursing Students’ monthly

allowance. The choices may include; below 2 000, 2 000 – 4 000, 4

001- 6 999, 7 000- 9 999, and 10 000 and above.

Delimitation of the Study

This study will be conducted to determine the perception on

Euthanasia of Nursing Students of Filamer Christian University

for the school year 2018-2019.

This survey-correlational research study will be conducted

among the one hundred twenty - eight (128) who will be selected

using stratified random sampling.

The primary research instruments that will be used in the

study are Perception on Euthanasia Questionnaire which will be

adapted and modified form. The dependent variable will be the

perception on Euthanasia. The independent variable will be the

profile of Nursing Students.

 The statistical tools that will be used to analyze and

interpret the data are frequency count, percentage, mean,

analysis of variance and T-test. All inferential tests are set at

.05 alpha levels.

Chapter 2

Review of Related Literature

Chapter 2 is a discussion of the literatures and the results

of other related researches to which the present study is related

or has some bearing or similarity. This chapter is divided into

three parts namely:

Part one, Perception on Euthanasia, is a discussion of

related literatures and journals on the perceptions of nursing

students about Euthanasia.

Part two, Synthesis, summarizes the literature reviewed in

the study.

Perception on Euthanasia
 Euthanasia can further be classified as active or passive,

where active euthanasia stands for direct administration of a

lethal agent to the patient by another party, which may or may

not be a physician, with a merciful intent. Active euthanasia can

be voluntary (on the patient's will), involuntary (without the

consent of patient in cases where it could be obtained), or non-

voluntary (in cases where consent of the patient cannot be

obtained due to his physical or mental disabilities). Passive

euthanasia, on the other hand, refers to suppressing or

withholding medical treatment with an intention of causing the

patient's demise. In contrast to this, in PAS, a patient self-

administers a lethal substance prescribed by the doctor

(EssayShark, 2017).

In 2001, Netherlands became the first country to have

formally legalized Euthanasia and PAS after about 30 years of

public debate. Since the 1980s, guidelines and procedures for

performing and controlling euthanasia have been developed and

adapted several times by the Royal Dutch Medical Association in

collaboration with that country's judicial system. Despite

opposition, including that from the Belgian Medical Association,

Belgium legalized euthanasia in 2002 after about 3 years of

public discourse that included government commissions (UKessays,

2018).
 The medical definition of euthanasia is “the act or practice

of causing or permitting the death of hopelessly sick or injured

individuals in a relatively painless way for reasons of mercy”

(Merriam-Webster, 2017). Opinions differ widely. Some people

retain a complete acceptance of the commandment ‘Thou shalt not

kill’ and the Hippocratic Oath, which according to some ethicists

are accepted by medical society and patients, both religious and

secular(Sztuka Leczenia, 2010).

Arguments fill contemporary debates over the moral and legal

status of assisted suicide and euthanasia. There is a great

contradiction in deciding between the aim and the ability of

medicine to sustain life and the requirement to relieve

suffering, and in many cases the two objectives become

incompatible. On both sides, there are many claims and

counterclaims that may not cohere with our empirical

understanding. To ensure evidence-based discussions and policy

formulation, it is important to consider three major points

regarding the practices of euthanasia (Ezekiel Emanuel, 2017).

First, euthanasia is rarely used, even in countries where

these interventions are legal and have been used for more than a

decade. Yet, according to the latest data from 2010, dying

patients have requested euthanasia in only about 6.7% of all

deaths (Lancet, 2012). The most recent study from 2014 suggests
that in the Netherlands 3.8% of deaths are by euthanasia, most of

which — about 92% of the 3.8% — are by euthanasia, and in

Belgium, only 4.6% of all deaths are by these interventions

(Lancet, 2012). These data means that the request about

legalizing euthanasia will help solve the problem of poor end-of-

life care is wrong.

Second, pain is not the primary reason why people seek

euthanasia. Many healthy people believe that pain would be the

reason why they may want them; however, evidence suggests

otherwise.

Third, many people believe euthanasia are flawless, quick

and painless (Lancet, 2012). Patients who request and receive

euthanasia or PAS infrequently experience pain; similarly, few

patients in pain actually want euthanasia. If not pain, then what

motivates patients to request euthanasia and PAS? Depression,

hopelessness, being tired of life, loss of control and loss of

dignity (Ezekiel Emanuel, 2017). These reasons are psychological

since they are clearly not felt physically, but by therapy and

anti-depressants.

In the states of Oregon and Washington, the reasons for

wanting euthanasia were: 90% of patients reported loss of

autonomy, 90% were less able to engage in activities that make

life enjoyable and 70% declared loss of dignity, where

hopelessness and depression are not recorded and are not included

in the reporting list, but still belongs on their group (Gillon

R. Euthanasia, 2010). In the Philippines, euthanasia is not legal

for the reason of the predominance of the religious communities

which hinders the ratification of the Euthanasia Bill. Also, the

majority of the Filipinos value the Christian doctrine as the

foundation of their conviction (De Guzman, R.A, 2013).

According to “Natural Death Act of 2005” of the Philippines

section 2, it is the policy of the State to value the dignity of

every person and guarantees full respect for human rights

(Santiago, M.D, 2008). However, it is still practiced by some,

mostly are from the poor segment of the country. They have no

other choice but to use euthanasia to stop the patient from

suffering, and to avoid expenses on medical treatments.

Additionally, medical technologies and professionals here in the

Philippines are not entirely advanced (De Guzman, R.A, 2013).

In spring 2015, the umbrella organization of German nursing

organizations (Deutscher Pflegerat) positioned the nursing

profession by publishing a paper that summarized the pros and

cons of assisted suicide. Health professionals working in

palliative care are likely to be confronted frequently with

euthanasia requests, regardless of their personal attitudes

toward assisting people in dying (Dierickx et al, 2018). In

ethical debates about euthanasia, the focus is often exclusively

on the involvement of physicians and the involvement of nurses is

seldom given much attention (T De Beer1, C Gastmans, and B

Dierckx de Casterlé, 2010). This involvement is not at all

limited to providing assistance in administering the lethal

medication, but includes the nurse’s role throughout the entire

process of euthanasia (Van de Scheur A and Van der Arend A,

2010). It is important for nurses to take part in discussion

about euthanasia; however, their views are rarely heard

(Towarzystwo Naukowe Katolickiego Uniwersytetu Lubelskiego,

2015).

June Mui Hing Mak and Michael Clinton point out that ‘what

is known about good death is largely known from the perspective

of the nurse’, rather than from that of the patient and the

family. Nurses have a unique and important role in the euthanasia

process in countries where it is legalized (Terkamo-Moisio et al.

2016). This process comprises registering the request for

euthanasia, participation in decision making, actually performing

the euthanasia, and aftercare (Van de Scheur A and Van der Arend

A, 2010). The professional ethics of nurses are based on moral

values, which also guide their arguments for or against

euthanasia. These ethics are documented in the international and

national guidelines. On the other hand, the ethical guidelines

emphasize the obligation of nurses to protect human life and

human rights, which include everyone’s right to life and security

of person (American Nurses Association, 2015).

According to Lopez-Castroman BMC Medicine (2017) there are

five other considerations for euthanasia requests: 1) the medical

condition conveys unbearable pain; 2) there is no prospect of

improvement; 3) available treatments are futile; 4) the person is

mentally competent to make a conscious and reasonable choice; and

5) the person is fully informed about the prognosis. Compared to

physicians, nurses are considered to be more involved with the

end-of-life care of patients, due to their greater bedside

attendance and frequent confrontation of patients’ suffering

(Kranidiotis G, Ropa J, Mprianas J, et al 2015). In some

countries, according to the Belgian euthanasia law, a

consultation with the nursing team which is directly involved in

the care of the patient is required before a physician can

perform the act of euthanasia (Bilsen J, Robijn L, Chambaere K,

et al, 2014). Despite the fact that euthanasia may be one of the

so called medical decisions along the end of life, it is still an

issue that greatly affects nurses.

Moreover, the proponents of euthanasia refer to the nurses’

duty to alleviate suffering (Ethical guidelines of nursing,

2015). The nurses are still the one who are at a central position
in the care of dying patients, where being confronted with

euthanasia request is unavoidable (Terkamo-Moisio et al. 2016).

Synthesis

From general perspective, Euthanasia is still an issue

filled with moral and ethical that is debatable until now. In

some countries, it has been legalize but in other, it has not.

Arguments fill contemporary debates over the moral and legal

status of assisted suicide and euthanasia. There is a great

contradiction in deciding between the aim and the ability of

medicine to sustain life and the requirement to relieve

suffering, and in many cases the two objectives become

incompatible. Debates about legalization of euthanasia continue

in a number of countries and states.

There are three major points regarding the practices of

euthanasia. First, euthanasia is rarely used, even in countries

where these interventions are legal and have been used for more

than a decade. Second, pain is not the primary reason why people

seek euthanasia. Many healthy people believe that pain would be

the reason why they may want them; however, evidence suggests
otherwise. If not pain, then what motivates patients to request

euthanasia is depression, hopelessness, being tired of life, loss

of control and loss of dignity?

These reasons are psychological since they are clearly not

felt physically, but by therapy and anti-depressants. The health

professionals working in palliative care are likely to be

confronted frequently with euthanasia requests, regardless of

their personal attitudes toward assisting people in dying.

Nurses in many states play a large role in inducing

euthanasia. The nurses’ role includes throughout the entire

process of euthanasia. They are the one who are at a central

position in the care of dying patients and considered to be more

involved where being confronted with patients’ suffering, and

euthanasia request is unavoidable. It is important for them to

take part in discussion about euthanasia, but their views are

rarely heard and in ethical debates, the involvement of nurses is

seldom given much attention. The ongoing debates are still very

much focused on the perspectives of the physicians and general

public ignoring the fact that the nurses are also one of the

facilitator, has the significant role and need for information

about their point of views in euthanasia.

 References

Asch DA (1996). The role of critical care nurses in euthanasia

and

assisted suicide. N Eng J Med; 334:1374–9.

Chambaere K, Vander Stichele R, Mortier F, N Engl J Med

(2015)
 Recent trends in euthanasia and other end-of-life practices

in Belgium; 372: 1179-1181.

Charlie L. Reeve, Steven G. Rogelberg, Christiane

Spitzmüller,

Natalie Digiacomo (2006), j.1559-1816.

De Guzman, R.A. (2013). Should Euthanasia Be Legalized in

the

Philippines?. Studymode.1354669.

Deliens, L. and J. Bernheim (2003). Palliative care and

euthanasia

in countries with a law on euthanasia. Palliative Medicine

17(5): 393–394.

Deliens L, van der Wal G. (2003) The euthanasia law in Belgium

and

the Netherlands. Lancet; 362(9391):1239-40.

Emanuel EJ (1994). The history of euthanasia debates in the

United

States and Britain. Ann Intern Med; 121: 793-802.

Ferrell B, Virani R, Grant M (2000). Beyond the Supreme

court
 decision: nursing perspectives on end-of-life care. Oncol

Nurs Forum; 27:445–55.

Groenewoud JH, van der Heide A, Onwuteaka-Philipsen BD, N Engl J

Med (2000). Clinical problems with the performance of

euthanasia and physician-assisted suicide in the

Netherlands; 342: 551-556.

Handbook of Vital Statistics Systems and Methods (2006), Volume

1:

Legal, Organisational and Technical Aspects, United Nations

Studies in Methods, Glossary, Series F, No. 35.

Hendin, H. (2004). The Case against Physician-Assisted

Suicide:

For the Right to End-of-Life Care. Psychiatric Times.

Hurst, S.A. and A. Mauron (2003). Assisted suicide and euthanasia

in Switzerland: Allowing a role for non-physicians. British

Medical Journal 326(7383): 271–273

Kuhse H, Singer P (1993). Voluntary euthanasia and the nurse:

an

Australian survey. Int J Nurs Stud; 30:311–22.

Marker, R. (2013). Euthanasia and Assisted Suicide: Frequently

 Asked Questions. Patients’ Rights Council.

Matzo M, Emanual EJ (1997). Oncology nurses’ practices of

assisted

suicide and patient-requested euthanasia. Oncol Nurs Forum;

24:1725–32.

MIller FG (2015). Treatment-resistant depression and

physician-

assisted death. J Med Ethics; 41:885–6.

Mystakidou K, Parpa E, Tsilika E, Katsouda E, Vlahos L (2000).

The

evolution of euthanasia and its perceptions in Greek culture

and civilization. Perspect Biol Med. Winter; 48(1):95-104.

Newman, T. (2018, February 7). "Sex and gender: What is

the

difference?." Medical News Today.

Nys H (2002). Euthanasia in the Low Countries: a

comparative

analysis of the law regarding euthanasia in Belgium and the

Netherlands. Ethical Perspect; 9(2-3):73-85.

Onwuteaka-Philipsen BD, Brinkman - Stoppelenburg A, Penning

C,
 Lancet (2012). Trends in end-of-life practices before and

after the enactment of the euthanasia law in the Netherlands

from 1990 to 2010: a repeated cross-sectional survey; 380:

908-915.

Oregon Public Health Division (2016). Oregon Death with

Dignity

Act annual reports, Oregon Health Authority.

Parker M. Moral (2000) intuition, good deaths and ordinary

medical

practitioners. J7ournal of medical ethics; 16: 28-34.

Parpa E, Mystakidou K, Tsilika E, Sakkas P, Patiraki E, Pistevou-

Gombaki K, et al (2006) The attitudes of Greek physicians

and lay people on euthanasia and physician-assisted suicide

in terminally ill cancer patients. Am J Hosp Palliat Care;

23(4):297-303.

Parpa E, Mystakidou K, Tsilika E, Sakkas P, Patiraki E, Pistevou-

Gombaki K, et al (2006) Attitudes of health care

professionals, relatives of advanced cancer patients and

public towards euthanasia and physician assisted suicide.

Health Policy; 97(2-3):160-5.

Rizvi SJ, Iskric A, Calati R, Courtet P (2017). Psychological and

 physical pain as predictors of suicide risk: evidence from

clinical and neuroimaging findings. Curr Opin Psychiatry;

30:159–6.

Rose Ann S. de Guzman (2013) Should-Euthanasia-Be-Legalized-

In-

The-1354669.

Shaw W. H. (1993), Social and Personal Ethics, Wadsworth

Publishing

Company: California.

Stevens CA (1994), Hassan R. Nurses and the management of death,

Dying and euthanasia. Med Law; 13:541–54.

Titchen A (2000). Professional craft knowledge in patient centred

nursing and the facilities of its development (doctoral

dissertation). University of Oxford.

Trachsel M, Irwin SA, Biller-Andorno N, Hoff P, Riese F (2016).

Palliative psychiatry for severe persistent mental illness

as a new approach to psychiatry? Definition, scope,

benefits, and risks. BMC Psychiatry; 16:260.

Ugur Cavlak, Ummuhan Bas Aslan, Suleyman Gurso, Nesrin Yagci,

Ipek

Yeldan (2007), Volume 24, Issue 1, pp 135–145.

 Chapter 3

Methodology

Chapter 3 is divided into three parts, namely: (1) Purpose

of the Study and Research Design, (2) Methodology and, (3)

Statistical Data Analysis Procedure.

Part One, Purpose of the Study and Research Design

summarizes the purpose of the study, defines the research design

and enumerates the variables that is used in the study.

 Part Two, The Method identifies the participants, the data

gathering, instruments that will be used, and the research

procedures apply in the study.

Part Three, The Statistical Data Analysis Procedure

enumerates the statistical tools used in the analysis of the

study.

Purpose of the Study and Research Design

This study will be conducted to determine the perception on

euthanasia of nursing students of Filamer Christian University in

terms of the sex, age, religion, civil status and monthly

allowance. The researchers will see that there will be several

students who can benefit from the results and findings of the
study: also it can contribute to the formulation of future

researches related with the topic.

This study will use a descriptive research, which attempts

to explore and explain while providing additional information by

using a survey or questionnaire aimed to describe the perceptions

of euthanasia.

Descriptive research is a research used to “describe” a

situation, subject, behavior, or phenomenon. It is used to answer

questions of who, what, when, where, and how associated with a

particular research question or problem. Descriptive studies are

often described as studies that are concerned with finding out

“what is”. It attempts to gather quantifiable information that

can be used to statistically analyze a target audience or a

particular subject. Description research is used to observe and

describe a research subject or problem without influencing or

manipulating the variables in any way. Hence, these studies are

really correlational or observational, and not truly

experimental. This type of research is conclusive in nature,

rather than exploratory (CIRT, 2018). The descriptive type of

research will be quantitative. The term descriptive refers to the

type of research question, design and analysis. In this study, it

will involve the gathering of 5-point Likert scale questionnaires

among the nursing students and will be analyzed using a

descriptive data analysis which describes the perception of

euthanasia in terms of sex, age, religion, civil status and

monthly allowance.

Methods

Participants

The research participants of this study will be the one

hundred twenty – eight (128) nursing students of Filamer

Christian University for school year 2018-2019. The sample size

of the student-participants in each year level is shown in Table

1. From the table, there are 109 from first year, 43 from third

year, and 36 from fourth year.

Table 1

Distribution of Respondents by Year Level

Level N n Percentage
First Year 109 74 58%

Third Year 43 29 23%

Fourth Year 36 25 19%

Total 188 128 100%

The respondents will be selected using the stratified random

sampling by means of drawing of lots. Stratified random sampling

will be used by drawing the sample from the population and then

drawing separate random samples from each stratum (Sullivan,

2008).

Data Gathering Instruments

To collect data for this research study, a 5-point Likert-

scale questionnaire will use to determine the perception of the

nursing students of Filamer Christian University. It will be

disseminated among 128 participants of Nursing Students of

Filamer Christian University.

 The questionnaire is composed of two parts, Part one

contains demographic information of the respondents, which

includes their sex, age, civil status, religion and monthly

allowance. Part two evaluates the knowledge and statements of

nursing students towards Euthanasia.

The Perception Questionnaire, a 15-item questionnaire was

adapted and modified from Shodhganga: a reservoir of Indian

theses is a digital repository of theses and dissertations

submitted to Indian universities, is answerable by a 5-point

Likert scale on the degree of agreement and scored as 1 - if

Strongly Disagree; 2 - if Disagree; 3 – if Uncertain; 4 – if

Agree; and 5 – if Strongly Agree.

To assess the reliability, a pilot-test will be done among

30 CCS students who are not participants of the study. The

questionnaire will be validated by a panel of experts and

alterations will be made including the reconstructions of

statements, afterwards it will be disseminated to the

respondents.

To interpret the result the following Arbitrary scale will be

used as follows:

Mean Description

4.21 – 5.00 - Highly Positive

3.41 – 4.20 - Positive

2.61 – 3.40 - Neutral

1.81 – 2.60 - Negative

1.00 – 1.80 - Highly Negative

Data Gathering Procedure

Foregoing to the conduct of the study, the researchers will

ask approval from the principal to conduct the study. Once the

permissions will be granted, the researchers will distribute the

questionnaires to the target respondents. Instructions will be

given clearly and once the questionnaires had filled up they will

be gathered and checked by the researchers for tabulation.

Data Analysis Procedure

 The data from completed questionnaires will be analyzed

using the SPSS and employing the following statistical tools:

Mean. This test will be used to measure the average score

for every reaction of the Nursing Students on Euthanasia.

Standard Deviation. Standard deviation is calculated based

on the mean. The distance of each data point from the mean will

be squared, summed and averaged to find the variance.

Frequency. A tabular representation of a survey data set

used to organize and summarize the data. Specifically, it is a

list of either qualitative or quantitative values that a variable

takes in a data set and the associated number of times each value

occurs (frequencies).

Percentage. Particularly useful method of expressing the

relative frequency of survey responses and other data.

Analysis of Variance. A statistical procedure used to test

the degree to which two or more groups vary or differ in an

experiment.

T-test. A t-test’s statistical significance indicates

whether or not the difference between two groups’ averages most

likely reflects a “real” difference in the population from which

the groups were sampled.