Nurses' ethical decision-making during end of life care in South Korea : a cross-sectional descriptive survey

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LIM, Arum | KIM, Sanghee

Background: Although nurses are crucial to ensure patients' peaceful death in hospitals, many nurses experience various ethical conflicts during end-of-life care. Therefore, research on nurses' entire ethical decision-making process is required to improve nurses' ethical decision-making in end-of-life care. This study aimed to identify Korean nurses' ethical decision-making process based on their moral sensitivity to end-of-life patients. Methods: In total, 171 nurses caring for terminal patients responded to the survey questionnaire. To measure the participants' moral sensitivity and ethical decision-making process, we used the Korean version of the Moral Sensitivity Questionnaire and Nurses' Ethical Decision-Making around End of Life Care Scale. Finally, multiple linear regression analysis was used to investigate the effect of moral sensitivity on nurses' ethical decision-making. Results: The mean of moral sensitivity was 4.8 ± 0.5 (out of 7), and that of ethical decision-making was 4.6 ± 0.5 (out of 6). Among the sub-dimensions of ethical decision-making, the highest score was in perceived professional accountability (5.2 ± 0.5), and the lowest in moral reasoning and moral agency (3.9 ± 0.6); the score of moral practice was 4.4 ± 0.7. In the multiple linear regression model, moral sensitivity (ß = 0.852, p < .001), clinical department (ß = - 7.018, p = .035), ethics education (ß = 20.450, p < .001), job satisfaction (ß = 5.273, p < .001), and ethical conflict (ß = - 2.260, p = 0.031) were influential ethical decision-making factors. Conclusions: This study revealed a gap between nurses' thoughts and practices through the ethical decision-making process. They failed to lead their thought to moral practice. It also implies that moral sensitivity could positively affect nurses' ethical decision-making. To make nurses morally sensitive, exposing them to various clinical cases would be helpful. Additionally, ethics education and clinical ethics supporting services are valuable for improving nurses' ethical decision-making. If nurses improved their ethical decision-making regarding end-of-life care, their patients could experience a better quality of death.

https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-021-00665-9

Voir la revue «BMC medical ethics, 22»

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