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Nurs Ethics. 2012 Sep;19(5):629-41.

'Ambivalence' at the end of life: how to understand patients' wishes ethically.

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Institute for Biomedical Ethics, University of Basel, Switzerland. kathrin.ohnsorge@unibas


Health-care professionals in end-of-life care are frequently confronted with patients who seem to be 'ambivalent' about treatment decisions, especially if they express a wish to die. This article investigates this phenomenon by analysing two case stories based on narrative interviews with two patients and their caregivers. First, we argue that a respectful approach to patients requires acknowledging that coexistence of opposing wishes can be part of authentic, multi-layered experiences and moral understandings at the end of life. Second, caregivers need to understand when contradictory statements point to tensions in a patient's moral experience that require support. Third, caregivers should be careful not to negatively label or even pathologize seemingly contradictory patient statements.

[Indexed for MEDLINE]

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