Examining the Role of Nurse Advocates in Ensuring Ethical Decision-Making During End-of-Life Care

Posted: Dec 05, 2024

• Gavin Torres
• Harper Brooks
• Julian Scott

Abstract

The integration of advanced medical technologies into end-of-life care has created unprecedented ethical challenges that transcend traditional biomedical paradigms. As healthcare systems increasingly rely on sophisticated life-sustaining technologies, the role of nurse advocates in navigating the complex intersection of clinical possibilities, patient preferences, and ethical considerations has become critically important. This research addresses a significant gap in the literature by examining how nurse advocates operationalize ethical decision-making in real-world end-of-life scenarios, moving beyond theoretical frameworks to understand the practical manifestations of advocacy in high-stakes clinical environments. End-of-life care represents a unique domain where technological capabilities often outpace ethical consensus, creating situations where multiple legitimate but conflicting values must be reconciled. Nurse advocates function as crucial mediators in these contexts, translating between medical expertise, patient values, and institutional constraints. Despite the recognized importance of this role, there remains limited empirical research examining how nurse advocates actually influence ethical decision-making processes and outcomes in end-of-life care settings. This study is grounded in the recognition that ethical decision-making in end-of-life care cannot be reduced to algorithmic processes or standardized protocols. Rather, it involves complex judgment calls that balance quantitative clinical data with qualitative human values. Nurse advocates bring a distinctive perspective to these decisions, combining clinical knowledge with intimate understanding of patient experiences and family dynamics. Their position at the bedside provides unique insights into how ethical principles are enacted—or compromised—in daily practice.