Influence of Formal Ethics Education on Nursing Students’ Concept of ‘Good Death'

Abstract

The concept of ‘good death' became widely discussed and studied in the late 60s of XX century. Neither the concept of ‘good death' nor the existing educational programmes in palliative care and their influence on the concept have been studied in Bulgaria. The objective of our study was to investigate the influence of formal ethics education on the concept of students about ‘good death' and to compare the most common concepts among healthcare professionals, relatives and students with experience in terminal care and those without any previous encounter with the dying process. The study employed a combination of sociological and statistical methods and involved 190 members of hospices personnel, 216 patients' relatives and 252 nursing students at different level of education. Leading concepts of good death among respondents without experience in care for terminally ill were painless death (49,5%), death in one's sleep (28,6%) and in-time death (26,4%). Among respondents with experience in care for terminally ill leading were painless death (54,3%), death in the neighborhood of relatives (32,6%), autonomy and control over death (28,3%). Opinion of students was studied in three different moments: before formal ethical discussions on the topic, after a movie presentation and in the end of the whole course. Ethics education influenced students' perception about ‘good death' and the number of identified concepts. A shift towards categories that value relation with family and presence of relatives was observed. Overall results pointed to painless death as a leading concept of ‘good death'. The study allowed defining a general concept of ‘good death' but we should bear in mind that the concept of ‘good death' varies and individual approach of caring for terminal patients is recommended. Formal ethics education contributes to the development of such professional approach and more humane attitude to dying patients.