Caring for an Unconscious Transgender Patient at the End of Life: Ethical Considerations and Implications.
Megan Lippe, Joshua C Eyer, William E Rosa and 5 others
PMID 33901059WHAT IT FOUND
A nurse cared for an unconscious trans woman whose mother, the legal next of kin, barred her friends and used male pronouns.
The team followed the law but missed chances to learn the patient's wishes or support her chosen family, leaving nurses in moral distress.
Key findings
01The mother restricted access to the patient and information, preventing the team from learning about her gender identity and support system from her friends.
02No palliative care consult was ordered, so the team did not assess the patient's values, beliefs, or preferences before she died.
03Nurses experienced moral distress and residue because they did not address disrespectful comments made by a physician during resuscitation.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a single case report, so it cannot show how often these ethical conflicts occur or which interventions effectively resolve them. The analysis relies on the authors' interpretation of one specific incident, which may not apply to all hospital cultures or legal frameworks. No patient outcomes were measured; the focus is entirely on the ethical process and staff experience.
Declared interests
The authors have no conflicts of interest to declare.
The easy way to misread this
Do not treat the proposed ethical frameworks as tested interventions. This paper describes one case and the authors' recommendations for practice; it does not provide evidence that these strategies improve patient outcomes or reduce staff distress.