Moral and Ethical Responsibilities Among Nurses in Geriatric Healthcare Decision-Making: A Phenomeonological Study

Abstract

This phenomenological study examined the moral and ethical responsibilities of nurses in geriatric healthcare decision-making in selected healthcare facilities in Davao, Philippines. Guided by Colaizzi’s descriptive method, in-depth interviews were conducted with eleven staff nurses who had at least one year of experience in caring for older adults. The study aimed to uncover how nurses navigate ethical dilemmas, interpret their professional responsibilities, and reconcile institutional policies with personal values and cultural beliefs. Participants were predominantly female (64%) and aged 35–44 years (73%), with most having 5–10 years of clinical experience. Analysis of the qualitative data generated seven key themes: (1) Ethical Principles in Geriatric Healthcare, (2) Ethical Dilemmas in Geriatric Practice, (3) Moral Responsibility and Ethical Reasoning in Nursing, (4) Institutional Support and Ethics Education, (5) Moral Distress and Emotional Labor in Geriatric Care, (6) Cultural and Contextual Factors in Ethical Decision-Making, and (7) Balancing Patient Needs with Personal Beliefs. Findings revealed that while nurses consistently applied ethical principles such as autonomy, beneficence, and justice, they frequently experienced tension when institutional policies conflicted with patient needs or family expectations. Moral distress was common, especially in end-of-life care, with nurses highlighting the emotional burden of ethically complex decisions. Cultural norms, personal beliefs, and religious values strongly shaped ethical reasoning, underscoring the need for culturally sensitive ethics education. The study concludes that ethical decision-making in geriatric nursing is a dynamic, reflective, and deeply personal process requiring sustained institutional support, targeted ethics education, and emotional resilience. Recommendations include integrating case-based ethics training, fostering reflective practice, establishing mentorship programs, and developing emotional support systems to mitigate moral distress among geriatric nurses.