The Impact of Nurses' Awareness of Ethical Issues in End-of-Life Care at Enugu State University Teaching Hospital
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Background of the Study
End-of-life (EOL) care is a critical aspect of healthcare that focuses on providing comfort, dignity, and quality of life for patients with terminal illnesses. Ethical issues often arise in EOL care due to complex decisions involving patient autonomy, withdrawal of life-sustaining treatments, palliative care, and family involvement (World Health Organization [WHO], 2024). Nurses, as primary caregivers, play a vital role in ensuring ethical principles such as beneficence, non-maleficence, and patient rights are upheld in EOL care (Brown & Taylor, 2023).
Despite established ethical guidelines for EOL care, studies have shown that nurses often struggle with ethical dilemmas, particularly in making decisions regarding do-not-resuscitate (DNR) orders, pain management, and communication with patients and families (Smith et al., 2024). Ethical awareness is essential for ensuring that patients receive compassionate and legally sound care at the end of life. However, the extent to which nurses are aware of ethical issues in EOL care at Enugu State University Teaching Hospital remains unclear.
Nurses’ ethical awareness directly impacts patient care outcomes and the emotional well-being of families dealing with loss. Insufficient ethical knowledge may lead to conflicts between healthcare providers, patients, and families, as well as increased moral distress among nurses (Williams & Johnson, 2024). Therefore, this study seeks to evaluate nurses' awareness of ethical issues in EOL care and its impact on their decision-making and patient outcomes.
Statement of the Problem
Ethical challenges in EOL care remain a major concern in healthcare settings, particularly in Nigeria, where cultural and religious beliefs significantly influence decision-making. Research has shown that many nurses feel unprepared to handle ethical dilemmas, leading to distress, burnout, and inadequate patient care (Gonzalez et al., 2023). The lack of standardized ethical training further complicates the ability of nurses to make informed decisions regarding EOL care (Taylor & Carter, 2024).
At Enugu State University Teaching Hospital, the level of nurses’ ethical awareness in EOL care has not been systematically studied. There is a need to understand how nurses perceive ethical issues, how they handle EOL situations, and what factors influence their ethical decision-making. Addressing these gaps will provide insights into the need for enhanced ethical training programs in nursing education and clinical practice.
Objectives of the Study
- To assess nurses' awareness of ethical issues in end-of-life care at Enugu State University Teaching Hospital.
- To examine how nurses' ethical awareness influences decision-making in EOL care.
- To identify challenges faced by nurses in addressing ethical dilemmas in EOL care.
Research Questions
- What is the level of nurses' awareness of ethical issues in EOL care?
- How does nurses’ ethical awareness impact their decision-making in EOL care?
- What challenges do nurses face in handling ethical dilemmas in EOL care?
Research Hypotheses
- Nurses at Enugu State University Teaching Hospital have a high level of awareness of ethical issues in EOL care.
- Nurses’ ethical awareness significantly influences their decision-making in EOL care.
- Ethical dilemmas and cultural beliefs impact nurses' ability to provide ethical EOL care.
Scope and Limitations of the Study
This study focuses on nurses working at Enugu State University Teaching Hospital who provide EOL care. It does not include other healthcare professionals or patients. Limitations may include personal biases in ethical perceptions and variations in experience with EOL care among nurses.
Definitions of Terms
- End-of-life (EOL) care: Healthcare provided to patients in the final stages of a terminal illness.
- Ethical awareness: The ability to recognize and address ethical dilemmas in clinical practice.
- Do-not-resuscitate (DNR) orders: Medical directives to withhold CPR in terminally ill patients.
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