End of life care: ethical issues

Nurses spend more time with patients who are facing the end-of-life than any other member of the health care team. Yet, studies have shown that many nurses feel inadequately prepared to provide the comprehensive care so important at the end-of-life. Penny Marshall, RN, PhD nursing professor at Johnson County Community College has recently attended a three-day course on end-of-life care held in Pasadena, CA. The American Associate of Colleges of Nursing (AACN) and the City of Hope (COH) National Medical Center received a 3 1/2 year grant from the Robert Wood Johnson Foundation to conduct this training program for undergraduate nursing school faculty members (Geraldine Bednash, PhD, FAAN and Betty R. Ferrell, PhD, FAAN, Principal Investigators). The training program, entitled End-of-Life Nursing Education Consortium (ELNEC), was conducted by distinguished faculty of researchers, educators, authors, and leaders in the field of palliative care; and aimed to provide faculty with comprehensive information on end-of-life care and resources to integrate into nursing school programs. The following two articles draw on this extensive curriculum to discuss two important aspects of end-of-life care: 1) common ethical dilemmas and complex questions that arise in the practice setting; and 2) symptom management during palliative care.