Nurses' Ethical Dilemmas Related To Caring Of Terminally Ill Patients: Integrative Literature Review
Kotilainen, Josephine Anyango (2025)
2025
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:amk-202601231704
https://urn.fi/URN:NBN:fi:amk-202601231704
Tiivistelmä
Ethical dilemmas arise when nurses care for terminally ill patients, which can occasionally clash with the Code of Ethics or the moral principles of the nurse, necessitating nurses to strike a balance when providing care. The purpose of this research is to identify gaps in the existing literature in order to stimulate researchers to develop strategies to guide ethical dilemmas among nurses faced with ethical dilemmas. The objective is to reveal the ethical dilemmas nurses encounter when caring for terminally ill patients, and how they can cope with them.
The study employed an Integrative Literature review (ILR). The data sources included ProQuest Central, EBSCOhost Combine search, and PubMed databases. The search terms were developed from the study's key words, and the appropriate inclusion and exclusion criteria were formulated to help limit the initial search. The data selection was guided and recorded by the PRISMA 2020 framework, in which 10 studies were selected. Quality appraisal was conducted using the QuADS tool, and the overall scores across the 10 included articles indicated that the studies are of high quality. Data extraction was conducted, and the summarised data of the included studies were recorded in a table.
The findings were classified into two themes: Ethical dilemmas nurses encounter when caring for terminally ill patients, and the coping strategies for nurses' ethical dilemmas when caring for terminally ill patients. The sub-themes regarding the ethical dilemmas nurses encounter when caring for terminally ill patients include: decision-making complexity and Nursing upholding Autonomy, health care system constraints and medical hierarchical experience, psychological and emotional strain, Ethical dilemmas among nurses, ethical dilemmas between prolonging life and alleviating suffering, Family and cultural constraints, and ethical dilemmas due to poor communication. The coping strategies sub-themes included: provision of training and an appropriate environment that safeguards patients' rights, promotion of appropriate communication skills, promotion of teamwork, moral courage, and reflection, Provision of an appropriate healthcare system and adequate resources.
This ILR will guide researchers, policymakers, and nurses to extensively understand more about Nurses ethical dilemmas in palliative care, calling for training, appropriate policies, a safe environment for nurses to talk about ethical dilemmas, and the recruitment of enough nurses in palliative settings.
The study employed an Integrative Literature review (ILR). The data sources included ProQuest Central, EBSCOhost Combine search, and PubMed databases. The search terms were developed from the study's key words, and the appropriate inclusion and exclusion criteria were formulated to help limit the initial search. The data selection was guided and recorded by the PRISMA 2020 framework, in which 10 studies were selected. Quality appraisal was conducted using the QuADS tool, and the overall scores across the 10 included articles indicated that the studies are of high quality. Data extraction was conducted, and the summarised data of the included studies were recorded in a table.
The findings were classified into two themes: Ethical dilemmas nurses encounter when caring for terminally ill patients, and the coping strategies for nurses' ethical dilemmas when caring for terminally ill patients. The sub-themes regarding the ethical dilemmas nurses encounter when caring for terminally ill patients include: decision-making complexity and Nursing upholding Autonomy, health care system constraints and medical hierarchical experience, psychological and emotional strain, Ethical dilemmas among nurses, ethical dilemmas between prolonging life and alleviating suffering, Family and cultural constraints, and ethical dilemmas due to poor communication. The coping strategies sub-themes included: provision of training and an appropriate environment that safeguards patients' rights, promotion of appropriate communication skills, promotion of teamwork, moral courage, and reflection, Provision of an appropriate healthcare system and adequate resources.
This ILR will guide researchers, policymakers, and nurses to extensively understand more about Nurses ethical dilemmas in palliative care, calling for training, appropriate policies, a safe environment for nurses to talk about ethical dilemmas, and the recruitment of enough nurses in palliative settings.