A nurse’s phenomenological enquiry into doctors’ end-of-life decision making

Abstract

This paper is based on an exploratory study conducted in a UK NHS oncology unit, informed by the interpretation of hermeneutic phenomenology by Van Manen and Dahlberg et al. Four senior oncology doctors (trainees) were recruited using homogenous purposive sampling. In-depth interviews were conducted to understand participants’ lived experience of decision making for oncology patients near the end of life. Analysis followed a line-by-line approach, with consideration of the lifeworld existentials identified by ( Van Manen, 1990 ). Common themes were uncovered of empathy, the unacknowledged influence; dichotomy and conflict; and subverted emotion (uncovered through reflection). Findings are discussed in relation to current clinical decision-making theory, particularly cognitive continuum theory, current UK end of life care policy and practice, role socialisation and inter-professional team working.