Trinity University of Asia

Cathedral Heights, Quezon City

Graduate School

Assessing the Ethical Decision Making of Staff nurse in End-of-Life Care: Towards Initial
to Culture Change

This tool is designed to describe the self-assessment of the staff nurse in their ethical decision
making skills in end of life care.

PART I: PROFILE VARIABLES

Direction: Kindly put a check mark on the blank before each item that applies to you.

1. Age

_____________
_____________

2. Years in the current Unit

3. Area of Assignment

General Nursing Unit

Special Nursing Unit
Ancillary Nursing Unit

4. Numbers of Training in End-of-Life

None

Care

1-2

3-5

6 or more
Roman Catholic

Muslim

Protestant

5. Religion

Others
Specify ______

Trinity University of Asia

Cathedral Heights, Quezon City

Graduate School

6. Ethnicity

Cebuano

Ilocano

Pangasinense

Kapampangan

Tagalog

Bicolano

Waray

Zamboangeno

Ilonggo

Others
Specify _____

7. Educational Attainment

BSN

Masters Degree

Doctorate Level

Others
Specify ______

PART II: SURVEY PROPER

Trinity University of Asia

Cathedral Heights, Quezon City

Graduate School

Direction: Please put a check mark () on the space provided that best describes your
judgment on the frequency of ethical dilemma that you encountered based on the following
scale:
Always
Often
Moderate
Sometimes
None

7 or more times
5-6 times
3-4 times
1-2 times
0

Frequency of Ethical Dilemma encountered by the staff nurse in the following dimensions:
I. Autonomy vs. Veracity
Administering a placebo to a patient

ALWAYS

OFTEN

MODERATE

SOMETIMES

NONE

ALWAYS

OFTEN

MODERATE

SOMETIMES

NONE

in pain.
Continuously managing the CPR
even if the patient has no chance of
surviving.
Not disclosing the doctor's poor
prognosis to the patient as per the
family's request.
Not divulging the information to the
patient regarding the chemotherapy
and its side effects as per the family's
request
II. Beneficence vs. Non Maleficence
Following the family's request to stop
all medication and nutritional therapy
of the patient.
Following the family's request for the
patient not to undergo necessary
medical treatment.
Following the instruction of the

Trinity University of Asia

Cathedral Heights, Quezon City

Graduate School

patient's relative, who is in the

medical field, to increase the narcotic
dose of the patient.
Following the familys

request

against the minors wish to continue

providing life sustaining measure
even though the minor patient is
experiencing chronic pain.
III. Veracity vs. Non Maleficence
Not disclosing the condition of an

ALWAYS

OFTEN

MODERATE

SOMETIMES

NONE

ALWAYS

OFTEN

MODERATE

SOMETIMES

NONE

ALWAYS

OFTEN

MODERATE

SOMETIMES

NONE

HIV/Aids positive patient to his

family as per his request.
Not
revealing
the

patient's

deteriorating

to

condition

his

relatives as per his request.

Not informing the patient regarding a
relatives death or ill condition as per
the family's request.
IV. Autonomy vs. Beneficence
Conforming the lifesaving treatments
to the patient's religious perspectives
and cultural beliefs.
Continuing the patient's

medical

treatment despite his refusal but in

accordance to the family's consent.
Following the patient's request not to
be put in a mechanical ventilator
even if the need arises.
V. Fidelity versus Beneficence
Informing the patient/relative that a
treatment will soon be stopped as

Trinity University of Asia

Cathedral Heights, Quezon City

Graduate School

evidenced by an improving recovery

parameters but due to a sudden
deterioration

of

condition,

the

treatment needs to be continue.

Promising a pediatric patient that has
difficulties taking medication that his
or her condition will improve if he or
she takes the medication.
Promising the patient that she/he will
be discharged soon as prescribed by
the physician but due to an abrupt
decline in vital parameters , the
discharge

order

is

put

on

hold/cancelled.

PART III: SURVEY PROPER

Direction: Please put a check mark () on the space provided that best describes your
opinion on the identified factors that enabled you to assess your decision making skills
based on the following scale:
5- Strongly Agree (Provision /Condition is present and facilitated (highly) in self-assessment)
4- Agree (Provision /Condition is present and facilitated (moderately) in self-assessment)
3- Neither agree nor disagree (Provision /Condition is present and facilitated (Fairly) in selfassessment)
2- Disagree (Provision /Condition is present and facilitated (Poorly) in self-assessment)

Trinity University of Asia

Cathedral Heights, Quezon City

Graduate School

1- Strongly Disagree (Provision /Condition is present and (Never) facilitated in self-assessment)

A: Self-Assessment of the Nurse on their Ethical Decision Making Skills in End of Life Care.
I. Recognition of Ethical Dilemma
5
1. The nurse acknowledge that there is an issue that deserve nurses

3 2

3 2

3 2

3 2

attention.
2. The nurse assess the values and beliefs of everyone involve.
3. The nurse identify the guidelines pertaining to end of life care.
4. The nurse consider how her behavior affect the situation.
II. Analyze the Ethical Dilemma
5
1. The nurse genuinely want to do the right thing.
2. The nurse want to determine the possible relationship between the
types of ethical dilemma.
3. The nurse evaluate the level of moral intensity represent in the
ethical dilemma encounter in end of life care.
III. Selection of Ethical Principle
5
1. The nurse determine what kind of ethical principle is best applied
to the situation.
2. The nurse decide what is good for the patient.
3. The nurse focus ethical principle.
4. The nurse base the choices on widely accepted ethical guidelines.
IV. Decision Making
1. The nurse are concerned on how goals are reached
2. The nurse conclude the importance of each potential approach.
3. The nurse evaluate alternative course of action.