Navigating Ethical Dilemmas in End-of-Life Care: Lived Experiences of Filipino Nurses

Abstract

Introduction: End-of-life care requires nurses to navigate complex ethical, emotional, cultural, and advocacy-related demands. However, the lived experiences of Filipino nurses in providing end-of-life care remain insufficiently explored, particularly regarding ethical decision-making, emotional adaptation, and patient advocacy. Objective: This study described the lived experiences of Filipino nurses in providing end-of-life care, particularly in ethical decision-making, emotional adaptation, patient advocacy, and personal and professional transformation. Methods: A descriptive phenomenological design was employed. Data were collected through semi-structured, in-depth interviews conducted either face-to-face or virtually with seven Filipino nurses working in different hospitals in the United States, most of whom were based in Oregon. Participants were recruited through purposive and snowball sampling. Reflexive journaling was used to support reflexivity and reduce the influence of the researcher’s preconceptions, and the data were analyzed using Colaizzi’s phenomenological method. Results: Four themes emerged from the participants’ experiences: (1) Prioritizing Comfort While Preserving Dignity at the End of Life; (2) Conflicting Views on End-of-Life Care; (3) Sentiments After Patients’ Passing; and (4) Experiential Changes in Filipino Nurses’ Personal and Professional Lives. Based on these findings, a preliminary debriefing guide was proposed by integrating key principles from the PEARLS and PAUSE frameworks. Conclusion: Filipino nurses remained committed to preserving patient dignity while navigating ethical dilemmas during end-of-life care. Their experiences reflected emotional adaptation, patient advocacy, and personal and professional transformation while supporting patients and families through the dying process.