Abstract
Background
Laws that regulate healthcare practice at the end of life reflect the values of the
society where they apply. Traditionally, healthcare professionals rely on their clinical
knowledge to inform treatment decisions, but the extent to which the law also informs
health professionals’ decision-making at the end of life is uncertain.
Objective
The objective of this study was to describe what healthcare professionals working
in emergency departments and intensive care units know about the law that relates
to end-of-life decision-making for hospitalised adults and what affects its application.
Review method
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
extension for scoping reviews.
Data sources
Data were sourced by searching the following databases: Cumulative Index to Nursing
and Allied Health Literature (CINAHL [via EBSCOhost]), Nursing and Allied Health and
Health and Medical Collection (via ProQuest Central), Excerpta Medica dataBASE (Embase),
PubMed, PsycINFO, and HeinOnline.
Results
Systematic screening of the search results and application of inclusion criteria resulted
in the identification of 18 quantitative and three qualitative articles that were
reviewed, summarised, and reported. Ten of the quantitative studies assessed knowledge
and attitudes to law or end-of-life decision-making using hypothetical scenarios or
vignettes. Qualitative studies focussed on how the law was applied when end-of-life
decisions were made. End-of-life decision-making is mostly based on the clinical needs
of the patient, with the law having a secondary role.
Conclusion
Around the world, there are significant gaps in healthcare professionals’ legal knowledge.
Clinical factors are considered more important to end-of-life decision-making than
legal factors. End-of-life decision-making is perceived to carry legal risk, and this
results in the provision of nonbeneficial end-of-life care. Further qualitative research
is needed to ascertain the clinician-related factors that affect the integration of
law with end-of-life decision-making.
Keywords
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Article info
Publication history
Published online: September 09, 2022
Accepted:
August 7,
2022
Received in revised form:
August 1,
2022
Received:
March 8,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.