Evident Death and Ethical Dilemma of the Immediate Life Support Nurse in the Context of Pre-Hospital Resuscitation: a Case Study

Abstract

Background: Ambulance nurses providing Immediate Life Support experience various out-of-hospital cardiorespiratory arrest situations, facing ethical dilemmas in cases of obvious death. Objectives: To analyze the ethical dilemma faced by Immediate Life Support nurses in deciding whether to initiate or suspend resuscitation maneuvers in cases of out-of-hospital cardiorespiratory arrest. Methods: This study follows a qualitative approach, centered on the analysis of a clinical case study, complemented by a narrative review of the scientific literature, which supports the reflection and justification of the ethical decisions under analysis. Results: The evidence suggests that despite the significant evolution of the Immediate Life Support ambulance project and the high level of qualification required of nurses, major divergences persist in the decision to initiate or suspend resuscitation maneuvers in out-of-hospital cardiorespiratory arrest. Conclusions: Considering European guidelines, the latest scientific evidence, and the ethical and legal framework governing the profession, a review of the National Institute of Medical Emergency protocols concerning the actions of nurses providing Immediate Life Support is necessary. Establishing guidelines that recognize their autonomy in deciding not to initiate or to suspend resuscitation maneuvers is crucial to mitigating ethical dilemmas and ensuring full respect for human dignity.