{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:08:56Z","timestamp":1782173336808,"version":"3.54.5"},"reference-count":44,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"unspecified","delay-in-days":149,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S1478951525000458_sec1a\">\n\t    <jats:title>Objectives<\/jats:title>\n\t    <jats:p>End-of-life care poses significant ethical challenges for nurses, requiring a deep understanding of moral empathy and ethical decision-making. This study examines the impact of these factors on end-of-life decision-making among nurses in oncology and pain management units in Egypt.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1478951525000458_sec2b\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>A cross-sectional design was employed to gather data from participants at a single point in time, facilitating an analysis of the relationships among ethical principles, moral empathy, and nursing practice. The study involved 246 registered nurses with at least 6 months of experience, selected through stratified random sampling from oncology and pain management units in Damietta, Egypt. These settings were chosen due to their central role in palliative care, as Damietta serves as a regional healthcare hub with specialized units addressing chronic and end-of-life conditions. This selection allows for an in-depth exploration of the ethical dimensions involved in providing palliative care. Informed consent was acquired from all participants, ensuring confidentiality and the right to withdraw from the study at any time.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1478951525000458_sec3c\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>The findings indicated that 72% of participants reported high levels of moral empathy, which positively correlated with ethical decision-making scores (<jats:italic>r<\/jats:italic>\u00a0=\u00a00.65, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01). However, 58% of the nurses also reported experiencing moderate to high levels of moral distress in various clinical scenarios. Additionally, nurses in supportive ethical climates experienced significantly lower moral distress than those in less supportive settings (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1478951525000458_sec4d\">\n\t    <jats:title>Significance of results<\/jats:title>\n\t    <jats:p>This study highlights the importance of integrating ethical training and moral empathy into nursing education and practice. The findings underscore the need for policy reforms to embed ethics and empathy training in nursing curricula and professional development programs, fostering ethical competence and enhancing patient care quality.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s1478951525000458","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T05:08:16Z","timestamp":1748581696000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":6,"title":["Ethics and moral empathy in end-of-life palliative care"],"prefix":"10.1017","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8192-0017","authenticated-orcid":false,"given":"Ateya Megahed","family":"Ibrahim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassanat Ramadan","family":"Abdel-Aziz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donia Elsaid","family":"Fathi Zaghamir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora H.","family":"Elneblawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Abd El-Rahman","family":"Elsaied Elhoty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasha kamal","family":"Sweelam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8264-3074","authenticated-orcid":false,"given":"Heba Ahmed","family":"Osman Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fathia gamal","family":"elsaid hassabelnaby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"S1478951525000458_ref20","doi-asserted-by":"publisher","DOI":"10.1136\/qshc.8.4.219"},{"key":"S1478951525000458_ref29","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2019.02902"},{"key":"S1478951525000458_ref35","first-page":"454","article-title":"Investigating factors associated with burnout among Italian healthcare workers during the COVID-19 pandemic: A cross-sectional study","volume":"24","author":"Prignano","year":"2024","journal-title":"BMC Psychiatry."},{"key":"S1478951525000458_ref38","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780197667149.001.0001"},{"key":"S1478951525000458_ref15","doi-asserted-by":"publisher","DOI":"10.1177\/0969733016679468"},{"key":"S1478951525000458_ref36","first-page":"236","article-title":"Moral distress among nurses in tertiary hospitals, southern Thailand","volume":"28","author":"Prompahakul","year":"2021","journal-title":"Nursing Ethics"},{"key":"S1478951525000458_ref40","first-page":"6","article-title":"The impact of COVID-19 on ethical decision-making in nursing: A scoping review","volume":"31","author":"Salas-Berg\u00fc\u00e9s","year":"2024","journal-title":"Nursing Ethics"},{"key":"S1478951525000458_ref23","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-024-02028-2"},{"key":"S1478951525000458_ref42","volume-title":"Handbook of Healthcare Ethics and Medical Law: Perspectives on Palliative Care","author":"Toro","year":"2023"},{"key":"S1478951525000458_ref37","first-page":"110","article-title":"An exploration of nurses\u2019 and social workers\u2019 perspectives on palliative care decision-making in a rural context: A qualitative descriptive study","volume":"14","author":"Riera-Negre","year":"2024","journal-title":"BMJ Supportive and Palliative Care"},{"key":"S1478951525000458_ref27","doi-asserted-by":"publisher","DOI":"10.1186\/s12960-023-00886-6"},{"key":"S1478951525000458_ref11","doi-asserted-by":"publisher","DOI":"10.1177\/1049909120978826"},{"key":"S1478951525000458_ref32","volume-title":"Venous Access: A Practical Textbook","author":"Moureau","year":"2023"},{"key":"S1478951525000458_ref12","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.44.1.113"},{"key":"S1478951525000458_ref17","doi-asserted-by":"publisher","DOI":"10.4324\/9781003262107"},{"key":"S1478951525000458_ref19","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-024-01865-5"},{"key":"S1478951525000458_ref24","unstructured":"Isufi, M , Kopin, D and Rexhepi, V (2024) The role of nurses in palliative care. 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Published by Cambridge University Press.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e108"}}