TY - JOUR
T1 - Ethical dilemmas and care actions in nurses providing palliative sedation
AU - Kwon, Sinyoung
AU - Kim, Miyoung
AU - Choi, Sujin
N1 - Publisher Copyright:
© The Author(s) 2022.
PY - 2022/8
Y1 - 2022/8
N2 - Background: Recently, palliative care is increasingly important, with an emphasis on the process of dying with dignity. However, nurses who care for such patients experience the associated ethical dilemmas. Objective: To explore the meaning of nurses’ experiences in dealing with ethical dilemmas in relation to palliative sedation. Research design: A qualitative research design was employed with a thematic analysis approach. Participants and research context: Using purposive sampling, 15 nurses, working at palliative care units for at least 1 year, were recruited as participants. Data were collected using unstructured in-depth interviews, and data collection and analysis was performed simultaneously. Ethical considerations: Ethical approval was obtained from the authors’ institutional review board. All participants provided informed consent. For the face-to-face interview, the South Korean standard COVID-19 quarantine guidelines, such as mandatory masking and social distancing, were followed. Results: Dilemmas raised by patients, were related to concerns about appropriate drug dose; dilemmas raised by nurses, were related to passive care, sense of guilt for failure to predict death, and colleague’s disrespectful attitudes toward patients; dilemmas from patients’ families were related to demands for palliative sedation and reversal of those demands. Care actions to deal with ethical dilemmas comprised evidence-based care, person-centered thinking, reflecting on the death situation, compassion, providing explanation and help to family members. Conclusion: Nurses’ ethical dilemmas were pre-dominantly influenced by themselves, rather than by the patients or their families, especially if they felt they could not do their best for patients. The core concept of care actions to deal with the ethical dilemmas, was person-centered care and compassion. Then, how patients and their family members perceive person-centered care and compassion, should be further explored to improve palliative sedation.
AB - Background: Recently, palliative care is increasingly important, with an emphasis on the process of dying with dignity. However, nurses who care for such patients experience the associated ethical dilemmas. Objective: To explore the meaning of nurses’ experiences in dealing with ethical dilemmas in relation to palliative sedation. Research design: A qualitative research design was employed with a thematic analysis approach. Participants and research context: Using purposive sampling, 15 nurses, working at palliative care units for at least 1 year, were recruited as participants. Data were collected using unstructured in-depth interviews, and data collection and analysis was performed simultaneously. Ethical considerations: Ethical approval was obtained from the authors’ institutional review board. All participants provided informed consent. For the face-to-face interview, the South Korean standard COVID-19 quarantine guidelines, such as mandatory masking and social distancing, were followed. Results: Dilemmas raised by patients, were related to concerns about appropriate drug dose; dilemmas raised by nurses, were related to passive care, sense of guilt for failure to predict death, and colleague’s disrespectful attitudes toward patients; dilemmas from patients’ families were related to demands for palliative sedation and reversal of those demands. Care actions to deal with ethical dilemmas comprised evidence-based care, person-centered thinking, reflecting on the death situation, compassion, providing explanation and help to family members. Conclusion: Nurses’ ethical dilemmas were pre-dominantly influenced by themselves, rather than by the patients or their families, especially if they felt they could not do their best for patients. The core concept of care actions to deal with the ethical dilemmas, was person-centered care and compassion. Then, how patients and their family members perceive person-centered care and compassion, should be further explored to improve palliative sedation.
KW - care action
KW - compassion
KW - ethical dilemmas
KW - nurses
KW - palliative sedation
KW - person-centered care
UR - http://www.scopus.com/inward/record.url?scp=85132733328&partnerID=8YFLogxK
U2 - 10.1177/09697330221105639
DO - 10.1177/09697330221105639
M3 - Article
C2 - 35728273
AN - SCOPUS:85132733328
VL - 29
SP - 1220
EP - 1230
JO - Nursing Ethics
JF - Nursing Ethics
SN - 0969-7330
IS - 5
ER -