Avoiding Futility: How Nurses and Physicians Experience Emotions, Psychosocial Factors, and Their Professional Roles as Influencing the End-of-Life Decision Making Process

In this qualitative study, five nurses and four physicians from intensive care settings were interviewed about their experiences of the end-of-life (EOL) decision making process. For both professional groups, a shared mission to avoid futility was identified as foundational and climactic aim to the process. This desire heavily shaped initiation and engagement of what was presented as an ambiguous decision making process. Three themes emerged of elements that most influenced their variable experiences of the EOL decision making process: moral weightiness, family receptiveness, and the individual philosophy of approach. These findings emphasize the wide amount of subjective variability experienced and shed light on the competing emotional, psychological, and social interests for ICU nurses and physicians in the EOL decision making process. There must be greater understanding of the EOL decision making process in an intensive care context to provide better support to nurses and physicians.