![]() Therefore, the ethical decision-making process of professional nurses should be investigated in-depth. In cases where nurses cannot properly deal with ethical dilemmas or conflicts, they may experience extreme stress and decreased quality of care. ![]() As a result, nurses who take care of EOL patients sometimes face ethical dilemmas, such as the futility of treatments, physician conflicts, confronting dying patients, or staffing shortages causing low-quality EOL care. However, in many cases, determining the best course of action regarding a patient’s EOL care is challenging, as such decisions usually directly affect a patient’s life and death. Thus, they encourage their patients to undergo peaceful death with dignity. When patients and their families consider withdrawing LST, nurses collaborate with multidisciplinary teams to ensure that patients have accurate information regarding their decisions. Further, they provide emotional and spiritual support to their patients and families. Nurses satisfy patients’ needs for optimal physical care, such as pain management, and promote a peaceful environment. According to the middle range theory, a peaceful end of life means patients do not experience pain but comfort and dignity. Nurses play an essential role in improving patients’ experience nearing end of life. In Korea, after the Act on Hospice and Palliative Care and Decisions on LST for EOL Patients was enforced in 2018, the number of registrants for advance directives has gradually increased. However, the number of people who want to die peacefully is considerable. Most of the decisions requiring a do-not-resuscitate order are made by the patients’ healthcare providers or family, and many patients spend their time undergoing various LSTs even if they are unlikely to recover. Nevertheless, patients still tend to be excluded from their end-of-life (EOL) decision-making. In 2018, more than three-fourths (76.2%) of the total number of deaths occurred in a medical setting. If nurses improved their ethical decision-making regarding end-of-life care, their patients could experience a better quality of death.Īs medical technology advancements have led to improvements in life-sustaining treatment (LST), the number of people who die in hospitals has increased in South Korea. Additionally, ethics education and clinical ethics supporting services are valuable for improving nurses’ ethical decision-making. To make nurses morally sensitive, exposing them to various clinical cases would be helpful. It also implies that moral sensitivity could positively affect nurses’ ethical decision-making. They failed to lead their thought to moral practice. ![]() This study revealed a gap between nurses’ thoughts and practices through the ethical decision-making process. Among the sub-dimensions of ethical decision-making, the highest score was in perceived professional accountability (5.2 ± 0.5), and the lowest in moral reasoning and moral agency (3.9 ± 0.6) the score of moral practice was 4.4 ± 0.7. ![]() The mean of moral sensitivity was 4.8 ± 0.5 (out of 7), and that of ethical decision-making was 4.6 ± 0.5 (out of 6). Finally, multiple linear regression analysis was used to investigate the effect of moral sensitivity on nurses’ ethical decision-making. To measure the participants’ moral sensitivity and ethical decision-making process, we used the Korean version of the Moral Sensitivity Questionnaire and Nurses’ Ethical Decision-Making around End of Life Care Scale. In total, 171 nurses caring for terminal patients responded to the survey questionnaire. This study aimed to identify Korean nurses’ ethical decision-making process based on their moral sensitivity to end-of-life patients. Therefore, research on nurses’ entire ethical decision-making process is required to improve nurses’ ethical decision-making in end-of-life care. Although nurses are crucial to ensure patients’ peaceful death in hospitals, many nurses experience various ethical conflicts during end-of-life care.
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