Avslutning av livsforlengende behandling: intensivsykepleierens rolle i beslutningsprosessen.

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Sammanfattning: Background: Overtreatment at end of life is a large ethical dilemma in today’s technologicalsociety. Studies show that the intensive care nurses role is little defined in the decisionmaking process of withdrawal or withholding life-sustaining treatment. Laws and guidelinesstates that the decision should be made interdisciplinary, the patients’ autonomy and right todecide is vital and the patients’ family must be involved in the discussion. Studies show thatthe doctor dominates the decision-making and that the decision making process is a source ofconflicts.Aim: To describe the intensive care nurses roles in the decision making process ofwithdrawing or withholding life-sustaining treatment.Method: A systematic review with systematic searches in medical and nursing orienteddatabases.Result: The main theme found is the intensive care nurses role as the patients advocate in thedecision making process. This through her engaging role, both emotional and professional andthe feeling of being left out of the decision making process. Lack of organizational structuresis identified, like guidelines, living will and teaching. The intensive care nurses role getsaffected by the team around the patient and how different views on the decision makingprocess contributes to conflicts, how the families need of support plays a role and what limitsthe intensive care nurses role.Conclusion: The role of the intensive care nurse is undefined in the decision-making process,but through the experience and accumulation of the clinical eye, she can develop to becomean advocate for the patient. She must then rely on her own expertise, use it to identify thepatient's existential needs and to further speak the patient's case.

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