Ruland and Moore’s Theory for Dignified Death in Palliative Care
DOI:
https://doi.org/10.70577/ccvfvj22Keywords:
palliative care; dignified death; patient autonomy; relief of suffering; nursing ethicsAbstract
Cornelia M. Ruland and Shirley M. Moore’s Peaceful End of Life Theory was critically examined in relation to the ethical tension between patient autonomy and relief of suffering in palliative care. A narrative review of literature published between 1998 and 2025 was conducted in PubMed, Scopus, and Web of Science, complemented by documents from the World Health Organization, the Pan American Health Organization, the European Association for Palliative Care, the Spanish Ministry of Health, and relevant regulatory frameworks. The thematic synthesis identified six axes: the prescriptive nature of the theory, relational autonomy, therapeutic proportionality, dignity in nursing care, justice in access, and implementation challenges. The findings showed that the theory translated ethical values into observable clinical outcomes like freedom from pain, comfort, peace, dignity, and meaningful closeness and provided a practical framework for deliberation when symptom control affected lucidity, communication, or relational presence. Structural, educational, and organizational barriers that hindered consistent implementation were also identified. It was concluded that the theory remained a valid reference for person-centered nursing and for the construction of dignified, compassionate, and ethically prudent dying processes.
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