Long-term care nurses' ethical convictions about tube feeding

Moral certainty, uncertainty, or both have an impact on every ethical decision confronted by the nurse. This article describes a qualitative study of the moral certainty and uncertainty experienced by long-term care nurses who are faced with the issue of withholding or withdrawing artificial nutrition and hydration from elders in the end stages of life. Moral certainty and uncertainty are analyzed as universal concepts, and the analysis is supported by the words of the study participants. Morally certain participants view tube feeding negatively and are likely to take some action when confronted with elders being tube-fed. The most common action is to educate families about tube feeding. Morally uncertain participants see the tube feeding as neutral or benign and are likely to take no action, but to maintain a strong belief that the elder should not suffer. Moral certainty and uncertainty are compared and contrasted and the findings discussed.