Abstract
The paper presents a research proposal tol explore and comprehend the experience of family members who are engaged in decision-making related to the withdrawal or withholding of life-sustaining interventions from another family member. The paper discusses the significance of the phenomenon to nursing and provides an overview of the methodology to be used in the study.

Outline:
Identification of Phenomenon of Interest
Statement of Research Purpose
Significance of the Phenomenon to Nursing
Research Question
Overview of Methodology

From the Paper
"The decision to remove life-sustaining interventions in the Intensive Care Unit (ICU) comprises a momentous event that encapsulates diverse experiences for families. Since clients often are incapable of communication, family members may confront severe complexities or even dilemmas in attempting to make end-of-life care decisions. This is primarily because of the nature of technology that is used in the ICU which is actually used for to opposing purposes of prolonging and terminating life. Exploring families' experiences is a significant phenomenon of concern to clients' families and the health care team, as well as for the provision of client-centered care."

Tags:end-of-life, life-sustaining, interventions, ethics, nursing

Abstract
This paper explores the decision to remove life-sustaining interventions in the Intensive Care Unit . According to the paper, this comprises a momentous event that encapsulates diverse experiences for families. The paper further addresses how family members may confront severe complexities or even dilemmas in attempting to make end-of-life care decisions.

From the Paper
"The decision to remove life-sustaining interventions in the Intensive Care Unit (ICU) comprises a momentous event that encapsulates diverse experiences for families. Since clients often are incapable of communication, family members may confront severe complexities or even dilemmas in attempting to make end-of-life care decisions. This is primarily because of the nature of technology that is used in the ICU..."

Tags:families, patient, life, support

Abstract
This paper explores the experience of family members who are engaged in decision-making related to the withdrawal or withholding of life-sustaining interventions from another family member. It explains that the methodology used consists of a sample of four to five families who are contacted through ICU family conferences in one or two hospitals in which the conferences are concerned with the withholding or withdrawal of life support from a family member. The paper looks at how certain factors may be identified from family members' experiences that help to determine why the decision-making process is subject to wide variation.
The paper also notes that it is expected that certain family members engage in more effective decision making than others and that particular families engage in more effective decision making than other families. The paper highlights the fact that family decisions are rendered easier or more problematic by such variables as the person's prognosis, whether an acute or chronic illness is involved, perceived quality of life, degree of suffering, and the presence of an advance directive. The paper concludes that preparation for death most especially needs to be based in a team approach, and the emphasis should be upon the relationship between nurses and families and that the future needs of the family should be proactively considered once death has occurred.

From the Paper
"Nurses and other healthcare providers normally initiate the discussion that lead to withdrawal of life-support but patients and families make the final decision. The experience of decision making is different for family members when an acute illness is involved from a situation of chronic illness. After a period of denial, families of patients with acute illness or injury can recognize the need for withdrawal of support much more quickly (McHale Wiegand, 2006). Certain behaviors by healthcare providers can increase the level of distress experienced by the patient's family."

Tags:euthanasia, nurse, life-sustaining, healthcare, providers, ICU, chronic, illness

Abstract
This research proposal involves an examination of how the decision to remove life-sustaining interventions in the intensive care unit (ICU) comprises a most significant event that encapsulates diverse experiences for families. The methodology used consists of a sample of four to five families who will be contacted through ICU family conferences in one or two hospitals. The research design is based on interpretive phenomenology, according to the work of M. van Manen and its focus on direct experience. The paper maintains that family members' experience of decision making related to withdrawal of life support is subjective, but also universal in many respects. The decision to withhold or withdraw interventions involves a complex process that occurs in stages. The paper concludes that the goal of the study is to show how this process is either facilitated or made more problematic for families.

Outline:
Introduction
Research Design
Theoretical Underpinning
Strengths and Limitations of Design
Participant Selection
Study Setting
Data Collection
Data Analysis
Steps to Ensure Rigor
Dissemination of Findings
Conclusion

From the Paper
"The theory underlying this study ultimately is found in the writings of Heidegger (1975, p. 11) who maintained that the individual worldview is not relative because whenever a worldview is developed, what it contains "can be formulated in propositions and rules which are related in their meaning to a specific really existing world". Individual experience, then, reflects universal experience. According to Phillips and Brown (1993), a critical hermeneutic approach proves useful in investigating the management of meaning. The approach is based on hermeneutics as an area of philosophy which relates to the theory and practice of interpretation, but is critical because it enables self-conscious reflection on social conditions. When the hermeneutic perspective is combined with a critical approach, the result is a structured approach to the analysis of the role of meaning in people's experience (Phillips & Brown, 1993). Researchers use the approach to associate ideas and symbols in ways which will explain the creation or maintenance of a permanent pattern of social relations. These include any activity which affects the network of symbols through which the individual or group understands reality. Critical hermeneutics is especially useful since it extends existing interpretive approaches (Phillips & Brown, 1993). The method can be used in longitudinal studies, in studies comparing cultural management, or in the study of groups and inter-group conflict."

Tags:terminal, illness, life-sustaining, interventions, family, decision

Abstract
The paper discusses a research study that will explore the experience of family members who are engaged in decision-making related to the withdrawal or withholding of life-sustaining interventions from another family member. The paper examines the role of healthcare providers in this situation, presents the research question and looks at the methodology to be used.

Outline:
Identification of Phenomenon of Interest
Statement of Research Purpose
Significance of the Phenomenon to Nursing
Research Question
Overview of Methodology

From the Paper
"Life-sustaining interventions have the potential to increase the life span of patients, yet termination of these interventions in ICUs is steadily increasing. Whereas providing the options regarding withholding or withdrawing treatment is common in the ICU environment, assisting family members as they struggle with these decisions on a personal level is extremely problematic (Abbott, Sago, Breen & Abernethy, 2001). The decision to withhold or withdraw these interventions involves a complex process for family members and occurs in stages (McHale Wiegand, 2006). For many family members, they are forced to become involved with decisions about which they have little or no information and have no preparation (McHale Wiegand, 2006)."

Tags:communication, healthcare, providers, nursing, withdrawal, intervention

Abstract
The paper discusses how the decision to remove life-sustaining interventions in the Intensive Care Unit (ICU) is a crucial event for families and family members often encounter real dilemmas when trying to formulate end-of-life care decisions. The paper relates that research into families' experiences has important potential both for the families' wellbeing as well as for the health care team in terms of providing enhanced client-centered care. The paper then discusses how the experience with the withdrawal of life support is not uniform for all families because of the operation of certain factors which influence the decision-making process. The paper notes that the one factor that decides the quality of the family's experience is the support received.

From the Paper
"The decision to remove life-sustaining interventions in the Intensive Care Unit (ICU) is a crucial event for families and family members often encounter real dilemmas when trying to formulate end-of-life care decisions. Research into families' experiences has important potential both for the families' wellbeing as well as for the health care team in terms of providing enhanced client-centered care. The experience with the withdrawal of life support is not uniform for all families..."

Tags:family, decisions, support

Abstract
This paper discusses families' experiences with the withdrawal of life support from a loved one in ICU (intensive care unit) and how it is not uniform for all families because of the operation of certain factors which influence the decision-making process. Finally, the paper discusses the impact of the support that these families receive and how it is the major factor that influences the quality of the family's experience.

Table of Contents:
Statement of the Problem and Purpose
Literature Review
Research Question
Theoretical Framework
Hypothesis #1
Data Collection
Research Design #1
Statistical Analysis #1
Hypothesis #2
Sampling Strategy #2
Data Collection #2
Research Design #2
Statistical Analysis #2
Conclusion

From the Paper
"Making decisions related to the withdrawal of life support in the ICU is one of the most demanding experiences the family will ever face. Nurses play a key role in the effectiveness of the decision making process and it is their understanding of the stages involved in that process which can determine the quality of the outcome. As McHale Wiegand (2006) maintains, as more families become involved in end-of-life decisions, it is essential that current research be assessed, the gaps in knowledge be identified, and that new directions for ongoing research should be established. Little is actually known about the interaction of nurses with families in this situation; what is certain is that the interaction is not uniform and that nurses need to realize what will be most effective with families who are experiencing high levels of stress."

Tags:stress, life, doctors, understanding

Abstract
This paper provides a brief proposal and outline for a research study in which the perceptions of family members who made the decision to terminate care for loved ones are reviewed. The research study seeks to test the degree of care provided and whether it is sufficient to meet the emotional needs of family members. Two hypotheses are proposed for testing.

Tags:proposal, nursing, end, of, life

Abstract
In this article, the writer notes that the decision to remove life-sustaining interventions in the intensive care unit (ICU) is a crucial event for persons responsible for end-of-life care decisions. Research into families' experiences with decisions to withdraw life sustaining interventions from a family member has indicated that the decisions made by the patient's immediate family can impact their perceptions and their psycho-social status. The writer discusses that appropriate educational and emotional support for families appears to improve their level of comfort regarding end-of-life decision-making and can facilitate the quality of the family's experience when dealing with difficult choices for a loved one. However, the literature in these areas demonstrates incongruity regarding how to best affect positive outlook among family members, and also the type of educational information needed and the methods required to deliver it. The writer therefore seeks to clarify which strategies are most effective in promoting a positive family experience when immediate family members make end-of-life decisions for a loved one receiving clinical health services.

Outline:
Introduction
Statement of the Problem and Purpose
Literature Review
Research Question
Hypotheses
Theoretical Framework
Hypothesis 1
Hypothesis 2
Conclusion

From the Paper
"Making decisions related to the withdrawal of life support in the ICU is one of the most demanding experiences the family will ever face. Nurses play a key role in the effectiveness of the decision making process and it is their understanding of the stages involved in that process which can determine the quality of the outcome. As McHale Wiegand maintains, as more families become involved in end-of-life decisions, it is essential that current research be assessed, the gaps in knowledge be identified, and that new directions for ongoing research should be established. Little is actually known about the interaction of nurses with families in this situation; what is certain is that the interaction is not uniform and that nurses need to realize what will be most effective with families who are experiencing high levels of stress."

Tags:hospitals, nurses, terminate, care

Abstract
This paper examines the controversial issue of withholding medical care and nutrition from a patient with a terminal illness or on life support. There have been several cases which have reached the high courts recently in which this matter is being argued. This paper explores which body has the right to decide if this treatment should be stopped - the medical facility, the family members or the court.

From the Paper
"What care is 'futile?' Throughout the years, the question of whether or not to withhold certain treatments to terminally ill patients has been addressed. Do we continue to treat people who are still alive, even if we know that there is no hope? This is a question that has been asked over and over again by various parties. This notion is an ethical dilemma because it involves the notion of ending a life by withholding medical attention. Some religious groups feel that patients should be treated at all costs up until the end, while other people disagree with the notion and say this is immoral; these people have such a low quality of life, they should be relieved of their pain and suffering as fast as possible. Much like abortion, another ethical dilemma, it is difficult to say which side is right or wrong. Hence, an analysis into the situation must be consiered."

Tags:medicine, ethics, euthenasia, family, court, patient, dilemna, futile, life, saving, right, die