Virtudes éticas e tomada de decisão de enfermeiros em cuidados paliativos oncológicos: uma análise qualitativa

Abstract

Introduction: Palliative care represents an approach aimed at improving the quality of life of patients and families facing chronic or life-limiting illnesses, especially in the context of cancer. With the aging of the population, the relevance of palliative care in public health grows, raising complex ethical dilemmas, such as life extension and human finitude. In this context, technological advancements and issues such as equity of access, breaking bad news, and autonomy in nursing care require in-depth analysis. Based on Aristotelian philosophy, this research explores the connection between virtues and ethical decision-making by nurses, highlighting the need for adequate preparation to face these challenges and improve care. Objective: To understand the relationship between virtues and nurses' preparation in decision-making regarding ethical issues in the context of palliative care in cancer. Methods: This is a generic qualitative study, descriptive and exploratory in nature, based on the Aristotelian theoretical framework. Data collection included participants' sociodemographic and educational profiles, as well as semi-structured interviews conducted between February and April 2024. Thirty-seven nurses from an oncology center and a philanthropic hospital in a municipality in Mato Grosso do Sul, Brazil, were interviewed. Data were processed using IRaMuTeQ (R Interface for Multidimensional Textual and Questionnaire Analysis) and analyzed using content analysis. Data collection was completed using exhaustion and saturation techniques, which ensured sample comprehension. Results: The descending hierarchical classification generated five classes, from which three categories of analysis were constructed: (1) Care practices and ethical-moral dimensions in palliative care: perspectives on pain relief and existential suffering; (2) Reflections on death and terminality; (3) Palliative care in oncology: virtue ethics in decision-making. Final considerations: Palliative oncology care, guided by virtue ethics, requires nurses not only to possess technical competence but also ethical reflection and moral sensitivity. This reinforces the urgency of training that integrates care, ethical-spiritual, and emotional dimensions into professional preparation. The research suggests curricular and institutional changes that promote spaces for listening, reflection, and emotional support for professionals, contributing to a more compassionate society and reaffirming humanized care as a fundamental right. Keywords: Palliative Care. Virtues. Nursing. Bioethics. Decision Making.