Nurses' involvement in end-of-life decisions

Area of Science:

• Palliative Care
• Medical Ethics
• Nursing Practice

Background:

• In Dutch healthcare, patients and physicians hold primary responsibility for end-of-life decisions.
• These decisions encompass a range of interventions including nontreatment, artificial hydration/nutrition withdrawal, pain management, euthanasia, and physician-assisted suicide.

Purpose of the Study:

• To investigate nurses' perspectives on their preferred and actual roles in discussing and making end-of-life decisions.
• To understand how nurses' involvement in end-of-life decision-making processes varies.

Main Methods:

• A survey was administered to 489 nurses involved in palliative terminal care.
• Nurses responded to questions regarding their preferred and actual roles in end-of-life decision-making.

Main Results:

• Nurses expressed a desire for greater involvement in end-of-life decisions, contingent on the decision's nature.
• 62% of nurses regularly discuss end-of-life decisions with patients or families.
• Approximately 75% of nurses participated in an end-of-life decision-making process in the past two years, primarily through communication with physicians and families.

Conclusions:

• Physicians should enhance communication with nurses regarding end-of-life decisions.
• Variations in nurses' roles based on their characteristics highlight the need for standardized processes in end-of-life decision-making.