The ethical obligation to provide care to patients diagnosed with brain death until the end stages based on grounded theory

Abstract

Nurses are faced with tremendous pressure when providing brain-dead patients with care. There is limited guidance for nurses on the care of these patients. The present study aimed to report the experiences of nurses regarding the care of patients diagnosed with brain death. Semi-structured interviews were conducted with 31 nurses and other stakeholders, and the observations and field notes were analyzed using continuous and comparative analysis based on grounded theory. The qualitative analysis of the data resulted in extraction of six final categories, including 'facing increased tensions and conflicts', 'organ donation: a distinct care element', 'inconsistency of care management', 'effective care requirements', 'challenges, rights and duty requirements', and 'moral obligation to provide holistic care until the last minute'. Data analysis identified 'Challenges, rights and duty requirements' as the main issue and showed that the nurses managed this issue using the strategy of 'moral obligation to provide holistic care until the last minute' as the core variable. According to the results, it is recommended that the healthcare system (especially hospital management) take supportive action for nurses in various fields of care of brain-dead patients to resolve educational, moral and legal challenges.

Keywords: Advance care planning; Brain death; Grounded theory.; Nurses; Tissue donors.

Figure 1

The theory of "Moral obligation to provide holistic care until the last minute"