Introduction: Intensive care unit is a demanding and dynamic clinical environment where healthcare professionals are confronted daily with ethical dilemmas regarding life and death decisions. These decisions often involve the use of advanced medical technologies, the necessity for rapid intervention, and cooperation with patients’ relatives, who are frequently under significant emotional distress. One of the most difficult decisions is the assessment of whether to continue or discontinue treatment, which requires consideration of the patient’s well-being, respect for their autonomy, and appropriate involvement of relatives in the decision-making process. Purpose: The purpose of this diploma work was to examine ethical dilemmas that arise in life and death decision-making in intensive care. Methods: We used a descriptive method, with a review of scientific and professional literature. Literature was obtained from bibliographic databases COBIB, CINAHL, PubMed as well as the search engines ScienceDirect and Google Scholar. Results: Ethical dilemmas often relate to decisions about continuing or withdrawing treatment in patients with no prospect of improvement. Challenges include moral distress among nurses, unclear roles within the healthcare team, lack of information, and weak communication. Key factors are team collaboration, involvement of relatives, and respect for patient autonomy and dignity. Discussion and conclusion: Ethical dilemmas often cause moral distress among healthcare staff, especially nurses, who play an important role in patient care but are frequently not directly involved in decisions about continuing or withdrawing treatment in intensive care. Key issues include lack of clear communication, unclear roles within the team, and insufficient involvement of relatives and palliative care in the decision-making process. It is necessary to strengthen the involvement of nurses in decision-making, provide professional education, develop clear guidelines, and promote open and empathetic communication between healthcare professionals, patients, and their relatives.
|
