Promoting patient decision making in life-and-death situations.

OBJECTIVES

To review factors in the health care culture that deny seriously ill patients' last wishes regarding care.

DATA SOURCES

Review articles and research studies that pertain to decision making.

CONCLUSIONS

Decision making in palliative care has been identified as an understudied area. Although there are significant benefits to being involved in treatment decision making, long-term follow-up of the consequences of active participation in the final stages of life is lacking.

IMPLICATIONS FOR NURSING PRACTICE

Nurses have a role to play in assisting patients and their families in treatment decision making in both the curative and palliative phase of care. A nursing intervention to promote patient involvement in decision making is described.