Nursing ethics in decision-making with palliative patients
DOI:
https://doi.org/10.56294/saludcyt20251582Keywords:
Palliative care, ethics, nursing ethics, moral, decision-makingAbstract
Ethical decision-making by nursing professionals is defined as a sequential process consisting of professional responsibility and moral components, such as moral sensitivity. Objective: To assess ethical conduct in nursing decision-making for palliative patients in an Oncology Hospital. A study was carried out with an observational, descriptive, retrospective and cross-sectional approach. The population consisted of 52 nursing professionals. The technique used was the questionnaire, one to determine moral sensitivity in the CuSMCE-23 and the other to measure the ability to make ethical decisions Decision Making Questionnaire II. According to the sociodemographic characteristics of the professionals, those aged 31 to 40 years (42.31%) showed a high degree of moral sensitivity. In the ability to make decisions, they reflected adaptation and clarity of criteria and objectives, but not for making a quick decision they considered to have little information. No significant differences were found between the degree of moral sensitivity and ethical decision-making. In conclusion, nursing staff have a high moral sensitivity for the care of palliative patients, however, they consider little information to make a quick decision, this being an essential aspect to guarantee a better quality of care in the face of ethical dilemmas.
References
[1] Quishpe V, Chipantiza M. Ética en enfermería, percepción de los receptores de cuidado. LATAM Rev Latinoam Ciencias Soc y Humanidades [Internet]. 2023;4(1):1–12. Disponible en: https://latam.redilat.org/index.php/lt/article/view/218
[2] Banderas J, Vázquez L, Hernández M. La ética del cuidado y la bioética en la calidad de atención por enfermería. Rev Peru Obstet y Enfermería [Internet]. 2016;12(2):1–9. Disponible en: https://portalrevistas.aulavirtualusmp.pe/index.php/rpoe/article/view/955
[3] Hajizadeh A, Zamanzadeh V, Kakemam E, Bahreini R, Khodayari R. Factors influencing nurses participation in the health policy-making process: a systematic review. BMC Nurs [Internet]. 2021;20(1):128. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC8273557/
[4] Carmona Y, Montalvo A. Sensibilidad moral de la enfermera ante el enfermo terminal. Investig y Educ en Enfermería [Internet]. 2019;37(3):1–14. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-53072019000300007&lng=en&nrm=iso&tlng=es
[5] Stephen M, Nyashanu M, Ossey C, Serrant L. Exploring the perceptions of dignity among patients and nurses in hospital and community settings: an integrative review. J Res Nurs [Internet]. 2021;26(6):537. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8899300/
[6] Cheraghi R, Valizadeh L, Zamanzadeh V, Hassankhani H, Jafarzadeh A. Clarification of ethical principle of the beneficence in nursing care: an integrative review. BMC Nurs [Internet]. 2023;22(1):1–9. Disponible en: https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-023-01246-4
[7] Baysal E, Sari D, Erdem H. Ethical decision-making levels of oncology nurses. Nurs Ethics [Internet]. 2019;26(7):2204–12. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30343627/
[8] Esmaelzadeh F, Abbaszadeh A, Borhani F, Peyrovi H. Strengthening ethical decision-making: the experience of Iranian nurses. Nurs Manage [Internet]. 2017;24(6):33–9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29115775/
[9] Viccón I, Ramos E. Conducta ética del personal de enfermería en el cuidado de los pacientes en hospitalización. Salud Quintana Roo [Internet]. 2016;9(33):18–23. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=103323
[10] Flores A, Zorrilla L, Araujo R, Trejo P, Reveles E. Desarrollo moral y conducta ética del estudiante de enfermería. Cienc Lat Rev Científica Multidiscip [Internet]. 2023;7(1):7192–211. Disponible en: https://ciencialatina.org/index.php/cienciala/article/view/4952/7527
[11] Cruz V, Cunuhay B. Aplicación de los principios bioéticos de las enfermeras profesionales del centro de salud no 3 Chambo-Riobamba durante la atención integral al usuario en el periodo Mayo-Agosto 2015. Univ Cent del Ecuador [Internet]. 2015; Disponible en: https://www.dspace.uce.edu.ec/entities/publication/d866a7e2-e9e2-4eda-bae2-90e0aa497376
[12] Morales M, Mesa M, Ramírez A, Pesántez M. Conducta ética del profesional de enfermería en el cuidado directo al paciente hospitalizado: Revisión sistemática. Arch Venez Farmacol y Ter [Internet]. 2021;40(3):1–14. Disponible en: https://www.redalyc.org/articulo.oa?id=55969712008
[13] Briones A. Percepción del paciente sobre la aplicación de principios bioéticos en los cuidados de los estudiantes de enfermería. Rev Colomb Enfermería [Internet]. 2020;19(3):5. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=7676174
[14] Campillo B. Creación y validación de cuestionario de sensibilidad moral en los cuidados enfermeros. Estudio de la sensibilidad moral enfermera. Univ Int Catalunya [Internet]. 2014; Disponible en: https://www.tesisenred.net/handle/10803/275985#page=1
[15] Prat M. La toma de decisiones como competencia enfermera para cuidar a pacientes crónicos con necesidad complejas. Univ Autónoma Barcelona [Internet]. 2021; Disponible en: https://www.tdx.cat/bitstream/handle/10803/673649/mpm1de1.pdf?sequence=1
[16] Sandoval I. Estilo de manejo de conflictos,relaciones interpersonales en la toma de decisiones de trabajadores del Policlínico Pablo Bermúdez, Lima, 2020. Univ César Vallejo [Internet]. 2021; Disponible en: https://repositorio.ucv.edu.pe/bitstream/handle/20.500.12692/57694/Sandoval_MIB-SD.pdf?sequence=1&isAllowed=y
[17] Luna A, Laca F. Patrones de toma de decisiones y autoconfianza en adolescentes bachilleres. Rev Psicol [Internet]. 2014;32(1):39–65. Disponible en: https://www.redalyc.org/pdf/3378/337831261002.pdf
[18] Toala R. Datos sobre ética de enfermería en la toma de decisiones con el paciente paliativo. Mendeley Data [Internet]. 2025; Disponible en: http://data.mendeley.com/datasets/8ksb2hfg5t/1
[19] Zeru T, Gerensea H, Berihu H, Zeru M, Wubayehu T. Nurses practice towards palliative care in Shire Endasilasie health facilities, Northern Ethiopia: a cross-sectional study. Pan Afr Med J [Internet]. 2020;35(1):110. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC7321685/
[20] Carmona Y, Montalvo A. Nurses’ Moral Sensitivity Regarding the Terminally Ill. Investig y Educ en Enferm [Internet]. 2019;37(3):e07. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC7871503/
[21] Afrasiabifar A, Mosavi A, Dehbanizadeh A, Khaki S. Nurses’ caring behaviour and its correlation with moral sensitivity. J Res Nurs [Internet]. 2021;26(3):261. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC8895006/
[22] Amiri E, Ebrahimi H, Areshtanab H, Vahidi M, Jafarabadi M. The Relationship between Nurses’ Moral Sensitivity and Patients’ Satisfaction with the Care Received in the Medical Wards. J caring Sci [Internet]. 2020;9(2):98–103. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32626672/
[23] Darzi M, Sadeghi A, Tapak L, Purfarzad Z. Relationship between moral sensitivity of nurses and quality of nursing care for patients with COVID‐19. Nurs Open [Internet]. 2023;10(8):5260. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC10333854/
[24] Rego F, Gonçalves F, Moutinho S, Castro L, Nunes R. The influence of spirituality on decision-making in palliative care outpatients: A cross-sectional study. BMC Palliat Care [Internet]. 2020;19(1):1–14. Disponible en: https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-020-0525-3
[25] Arends S, Thodé M, De Veer A, Pasman H, Francke A, Jongerden I. Nurses’ perspective on their involvement in decision‐making about life‐prolonging treatments: A quantitative survey study. J Adv Nurs [Internet]. 2022;78(9):2884. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC9541323/
[26] Bos-van D, Thodé M, Jongerden I, Van Laarhoven, Hanneke Smets E, Tange D, Henselmans I, et al. The role of hospital nurses in shared decision‐making about life‐prolonging treatment: A qualitative interview study. J Adv Nurs [Internet]. 2020;77(1):307. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC7756397/
[27] Luo Z, Tao L, Wang C, Zheng N, Ma X, Quan Y, et al. Correlations between moral courage, moral sensitivity, and ethical decision-making by nurse interns: a cross-sectional study. BMC Nurs [Internet]. 2023;22(1):260. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC10408053/
[28] Lim A, Kim S. Nurses’ ethical decision-making during end of life care in South Korea: a cross-sectional descriptive survey. BMC Med Ethics [Internet]. 2021;22(1):94. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8285824/.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Roxanna Monserrate Toala Vera, Sandra Linares Giler (Author)

This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.