Abstract:
Background: Withholding and withdrawing life support measures from terminally ill
patients are challenges in clinical practice, particularly in the ICU; it brought different
opinions among healthcare workers and still there is no consensus on this practice.
However, in some countries there are guidelines that help and support clinicians in making
ethical decisions of withholding and withdrawing life support measures from terminally ill
patients. In Tanzania, there is neither guideline nor legal frameworks governing the
practices; these subjected healthcare workers in serious ethical dilemmas in end of life
ethical decisions making.
Objectives: To explore the perspectives of healthcare workers on withholding and
withdrawing life supportive measures from terminally ill patients at Bugando Medical
Centre, Mwanza region-Tanzania.
Methods: A qualitative descriptive (QD) study was used to explore perspectives of
healthcare workers regarding withdrawing and withholding life support from terminally ill
patients in the ICU. In depth interviews were used to collect information from thirteen
participants using a semi structured interview guide. An appointment was made with
nurses and physicians depending on their availability. Data were analyzed using qualitative
content analysis.
Results: A healthcare workers perspectives varies in ethical decisions of withholding and
withdrawing life supportive measures from terminally ill patients. However, healthcare
workers face many challenges in making ethical decisions when caring terminally ill
patients ICU.
Conclusions: The ethical decisions of withholding and withdrawing life support measures
from terminally ill patients in AICU of Bugando Medical Centre face many challenges.
However, there is significant factors which believed by health care workers to consider
when withhold or withdrawing life support measures from terminally ill patients. Due to
lack of legal and ethical framework to guide the practices, physicians and nurses fear to
make professional decisions regarding terminally patients.
