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Ethical Issues

Ethical Issues

Nurses are essential in patient care, upholding the ethical principles of their profession and effectively navigating ethical dilemmas. Neglecting ethical issues can lead to inadequate patient care, compromised therapeutic relationships, and moral distress among healthcare workers.
Ethical Concerns in Healthcare:

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Ethical Dilemmas II

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Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
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How nurses in China navigate end-of-life communication: A qualitative study.

Chengcheng Pei¹, Jiaxin Wang¹, Jingcheng Wang¹

¹School of Nursing, Faculty of Medicine, Yangzhou University, Yangzhou, 225009, PR China.

International Journal of Nursing Studies

|May 20, 2026

Summary

Nurses in China learn to navigate end-of-life communication through experience, moving from hesitant to balanced approaches. Continued education and support are vital for culturally sensitive care.

Keywords:

Culture End-of-life communication Nurses Palliative care Qualitative research

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Area of Science:

Nursing
Medical Ethics
Cross-cultural Communication

Background:

End-of-life communication presents unique challenges in China due to cultural norms like family-centered decision-making and death taboos.
Nurses require specific skills to navigate these sensitive conversations effectively.

Purpose of the Study:

To explore how experienced registered nurses in China learned and adapted to end-of-life communication within their cultural context.
To describe the process of developing competence in culturally sensitive end-of-life care.

Main Methods:

Qualitative descriptive study utilizing semi-structured, face-to-face interviews with 26 registered nurses.
Data collected from three tertiary hospitals in Jiangsu Province, China, and analyzed using reflexive thematic analysis.
Purposive and snowball sampling methods were employed for participant recruitment.

Main Results:

Nurses described an evolving learning process, moving from initial hesitation and cultural constraints to more balanced communication strategies.
Key themes included "Hesitant beginnings," "Ongoing transformation," "Mediating practices," and "Empathic realism."
Accumulated experiences significantly contributed to nurses' professional growth in end-of-life communication.

Conclusions:

Nurses in eastern China develop end-of-life communication skills through experience, transitioning towards more effective and balanced approaches.
While experience is crucial, targeted education and organizational support are essential for enhancing culturally sensitive end-of-life care.
Further development of policies and training programs can improve nurses' ability to manage end-of-life conversations in diverse cultural settings.