Nursing interventions about nutrition and hydration in the end of life care: A nursing ethical perspective

Introduction: Nutrition and hydration in the end life care should be consistent with the WHO definition of palliative and end of life care, with the overall goal to improve quality of life (Holmdahl, 2014). Artificial food and fluid administration is one of the most frequently withheld life-sustaining treatments (van der Maas et al. 1996, Groenewoud et al. 2000, Bosshard et al. 2005). As a result, actually, nurses become closely involved in complex ethical decision-making processes concerning artificial administration of food or fluids for these patients (Bryon, 2008). Aim: The aim of this study will be to conduct a systematic literature review about nursing interventions in end of life care and to describe nurse’s ethical dilemma in the decision-making processes during end-of-life care. Method: Bibliographic search will be performed through six electronic databases. The reference lists of relevant papers will be also examined. The articles retrieved will be critically reviewed. Results: The inclusion criteria are: articles published from 2000 to 2017. The key-words include, nursing professional autonomy, nursing intervention, nutrition or hydration and ethics or bioethics, and palliative care or care at the end of life. Discussion: Although their direct impact is limited, nurses play a substantial direct action during decision-making processes. Their function is to be the patient supporters and provide supervision, information and support to patients, families and caregivers. Conclusion: Nutrition and Hydration are highly important at the end of life, but sometimes the actions and the assistance during this process need great empathy. The expected results are related to: nurses activities on nutrition and hydration administration, to the roles and rules of these activities and at the end to the emotions and the feelings concern on the decision-making process and end of life decisions.