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Maintaining Dignity at the end of life in the Emergency Department
  1. Pippa Deith
  1. Pippa Deith is Home Care Clinical Nurse Specialist, St Christopher’s Hospice, London. Previously, she worked in a large accident and emergency department. Email: p.deith{at}


The main aims of nursing care at the end of life include relieving suffering, improving sense of wellbeing and helping patients to die peacefully and with dignity. Dignity at the end of life is a subjective concept. However, there are certain fundamental principles that are deemed essential to the maintenance of a dying patient’s dignity, e.g. holistic assessment and care, privacy, symptom control, provision of choice and psychological and spiritual support. Many of these principles are challenging to promote in emergency environments where the priorities of care tend to focus on active, life-saving treatment and interventions. This article describes the assessment and management of a terminally ill patient who was admitted to an emergency department, where he subsequently died. The patient had previously drawn up an advance care plan indicating his wish to die at home and not be subjected to further active treatment. The discussion pays particular attention to the patient’s dignity and how it was undermined or upheld. The patient’s anonymity has been maintained by the use of a pseudonym and changing other identifying details (Nursing and Midwifery Council, 2008). Conflicts of interest: none

  • Advance care planning
  • Dignity
  • Emergency care
  • End-of-life care
  • Futile interventions
  • Symptom distress

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