Moral distress in end-of-life decisions: A qualitative study of intensive care physicians

The aim of this study was to assess attitudes of intensive care nurses to selected ethical issues related to end-of-life decisions in paediatric intensive care units. A self-administered questionnaire was distributed in 2005 to intensive care nurses at two different scientific occasions in Turkey. Of the 155 intensive care nurse participants, 98% were women. Fifty-three percent of these had intensive care experience of more than four years. Most of the nurses failed to agree about withholding (65%) or withdrawing (60%) futile treatment. In addition, 68% agreed that intravenous nutrition must continue at all costs. In futile treatment cases, the nurses tended to leave the decision to parents or act maternalistically. The results showed that intensive care nurses could ignore essential ethical duties in end-of-life care. We suggest that it is necessary to educate Turkish intensive care nurses about ethical issues at the end of life.

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End-of-life decisions in adult intensive care: Current research base 158 and directions for the future

Nursing Outlook ◽

10.1067/mno.2000.100364 ◽

2000 ◽

Vol 48 (4) ◽

pp. 158-164 ◽

Cited By ~ 25

Author(s):

Judith Gedney Baggs ◽

Madeline H. Schmitt

Keyword(s):

Intensive Care ◽

End Of Life ◽

End Of Life Decisions ◽

The Future ◽

Life Decisions

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Psychological support in end-of-life decision-making in neonatal intensive care units: Full population survey among neonatologists and neonatal nurses

Palliative Medicine ◽

10.1177/0269216319888986 ◽

2019 ◽

Vol 34 (3) ◽

pp. 430-434 ◽

Cited By ~ 3

Author(s):

Laure Dombrecht ◽

Joachim Cohen ◽

Filip Cools ◽

Luc Deliens ◽

Linde Goossens ◽

...

Keyword(s):

Intensive Care ◽

End Of Life ◽

Intensive Care Units ◽

Neonatal Intensive Care ◽

Psychological Support ◽

Neonatal Intensive Care Units ◽

End Of Life Decisions ◽

Life Decisions ◽

End Of Life Decision ◽

Life Decision

Background: Moral distress and burnout related to end-of-life decisions in neonates is common in neonatologists and nurses working in neonatal intensive care units. Attention to their emotional burden and psychological support in research is lacking. Aim: To evaluate perceived psychological support in relation to end-of-life decisions of neonatologists and nurses working in Flemish neonatal intensive care units and to analyse whether or not this support is sufficient. Design/participants: A self-administered questionnaire was sent to all neonatologists and neonatal nurses of all eight Flemish neonatal intensive care units (Belgium) in May 2017. The response rate was 63% (52/83) for neonatologists and 46% (250/527) for nurses. Respondents indicated their level of agreement (5-point Likert-type scale) with seven statements regarding psychological support. Results: About 70% of neonatologists and nurses reported experiencing more stress than normal when confronted with an end-of-life decision; 86% of neonatologists feel supported by their colleagues when they make end-of-life decisions, 45% of nurses feel that the treating physician listens to their opinion when end-of-life decisions are made. About 60% of both neonatologists and nurses would like more psychological support offered by their department when confronted with end-of-life decisions, and 41% of neonatologists and 50% of nurses stated they did not have enough psychological support from their department when a patient died. Demographic groups did not differ in terms of perceived lack of sufficient support. Conclusion: Even though neonatal intensive care unit colleagues generally support each other in difficult end-of-life decisions, the psychological support provided by their department is currently not sufficient. Professional ad hoc counselling or standard debriefings could substantially improve this perceived lack of support.

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