Finnish nurses' interpretations of patient autonomy in the context of end-of-life decision making

Nurs Ethics. 2006 Jan;13(1):41-51. doi: 10.1191/0969733006ne856oa.


Our aim was to study how nurses interpret patient autonomy in end-of-life decision making. This study built on our previous quantitative study, which evaluated the experiences of and views on end-of-life decision making of a representative sample of Finnish nurses taken from the whole country. We performed qualitative interviews with 17 nurses and analysed these using discourse analysis. In their talk, the nurses demonstrated three different discourses, namely, the 'supporter', the 'analyst' and the 'practical' discourses, each of which outlined a certain position for patients and relatives, and a certain identity for the nurses in end-of-life decision making. The nurses' talk showed notable differences when compared with that of physicians, highlighting the differences that take place in respect of the image of a person's work, professional culture, professional identification and responsibilities. An important finding was that the nurses often described their participation in end-of-life decision making in terms of indirect influence.

MeSH terms

  • Advance Directives
  • Attitude of Health Personnel
  • Data Collection
  • Female
  • Finland
  • Humans
  • Nurse-Patient Relations*
  • Nurses / psychology*
  • Patient Participation*
  • Personal Autonomy
  • Terminal Care*
  • Withholding Treatment