Exploring the Ethical Challenges Faced by Nurses in End-of-Life Care: Perspectives from Practitioners

Abstract

End-of-life care (EOLC) is one of the most ethically complex aspects of nursing practice, particularly in the government healthcare sectors of the Kingdom of Saudi Arabia. This study explores the ethical challenges faced by nurses in EOLC through qualitative interviews with 25 nurses. Major themes identified include communication barriers, cultural considerations, emotional burden, resource constraints, and conflicts between patient autonomy and medical advice. Statistical analysis revealed significant associations between these challenges and factors such as work settings, specialization, and years of experience. Nurses in tertiary hospitals reported higher communication challenges, while cultural considerations were more prevalent among oncology and palliative care nurses. Younger and less experienced nurses faced greater emotional burdens, highlighting the need for targeted support mechanisms. The study emphasizes the importance of interventions such as communication training, cultural competence education, emotional support systems, and policy reforms to address resource limitations. These findings provide actionable insights to enhance ethical decision-making and improve the quality of care in EOLC settings.