“Dying with Dignity” Through Nurses’ Eyes: Experiences and Ethical Meanings in Palliative Care

Background: Death with dignity is a core principle of palliative care, emphasizing patient autonomy, comfort, and holistic support at the end of life. While the concept has been widely discussed in Western healthcare systems, limited qualitative evidence exists regarding how palliative care nurses perceive and enact death with dignity within the Turkish healthcare context. Methods: This study employed a qualitative descriptive phenomenological design. Semi-structured, face-to-face interviews were conducted with 19 nurses working in oncology and anesthesiology palliative care units of a training and research hospital in Türkiye. Data were audio-recorded, transcribed verbatim, and analyzed using inductive thematic content analysis with MAXQDA 20 software. Results: Seven main themes emerged from the analysis: components of death with dignity, patients’ and relatives’ demands during the terminal period, effectiveness of physiological care at the end of life, rights of the dying person, the impact of palliative sedation on death with dignity, communication about death with terminally ill cancer patients, and approaches to patients, relatives, and the environment after death. Nurses primarily associated death with dignity with effective symptom management, physical comfort, and spiritual support. They frequently reported challenges in discussing death with patients, uncertainties related to patient autonomy and end-of-life rights, and ethical ambiguities surrounding palliative sedation. Post-mortem care was strongly linked to maintaining dignity through hygiene, privacy, and respect for cultural and religious practices. Conclusion: The findings indicate that while palliative care nurses in Türkiye play a critical role in supporting death with dignity, gaps remain in end-of-life communication, legal and ethical clarity, and bereavement support. Strengthening education on patient rights, death communication, and palliative sedation, alongside the development of clearer institutional and legal frameworks, may enhance dignified, patient-centered end-of-life care.