The driving force behind mandates from both the American Nurses' Assoc
iation and the American Medical Association is an expectation that doc
tors and nurses will act as advocates for the participation of the pat
ient in end-of-life treatment decisions. This mandate assumes that bot
h groups are knowledgeable about advance directives and can advise pat
ients on these. Both groups are enjoined not only to facilitate the ex
pression of the patient's wishes but also scrupulously to honor these.
The literature suggests that, despite their professional mandate, nur
ses may feel uncertain about the legal, moral, and ethical obligations
surrounding their participation in this enormously significant aspect
of patient care. This study focuses on the perception of the dilemma
by a sample of registered nurses at a large southeastern university me
dical center.