Withholding and withdrawing life support measures from terminally ill patients: perspectives of healthcare workers at Bugando medical centre, Mwanza region-Tanzania

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.