This research examines the concept of the living will from a nursing perspective. A living will is a written and witnessed advanced directive that communicate a patient's care preferences (Singleton, Dever, and Donner, 1992, pp. 41 46). Living wills generally apply in the context of terminal illness or irreversible coma (Grant and Huntington, 1989b, p. 93). Living wills provide a means by which patients and families may describe their wishes and set forth legal guidelines for nurses and physicians (Bellocq, 1988, pp. 168 175; Shook, 1992, pp. 30 34).
Nurses in the 1990s, as is true of all health care professionals, are being confronted with an array of issues that contain moral dimensions (Clarke, 1991, pp. 22 25). These issues include considerations of a patient's right to die (Laben, 1990, pp. 1 2) to adhering to physicians' "do not resuscitate" orders (Yarling, 1990, pp. 327 334).
That nursing is based on a moral foundation is recognized (Yarling, 1990, pp. 335 342). The professional obligations of nurses demand that nursing personnel have a grasp of the ethical bases of their profession (Hussey, 1990, pp. 1377 1382. One issue within this context concerns the efficacy and feasibility of the relating of natural sociology and moral questions within the nursing context (Johnson, 1990, pp. 1358 1362).
The practice of nursing takes place within a culture (McElmurry and Zabroki, 1989, pp. 1041 1050). This culture is the pattern of individual attitudes and orientations among the members of both the nursing profession and the larger society of which the profession is a part. It is the subjective realm that underlies and give meaning to nursing actions. The components include cognitive orientations, affective orientations and evaluative orientations, or, in other words, judgments and opinions about factors involved in the process of nursing.
Controversy surrounds the concept of a patient's right to die and the exercise o...