Abstract
Ethical issues at end of life are not primarily medical or science issues but social, legal, religious, and cultural. This article will provide a background for addressing ethical dilemmas in palliative and end-of-life care from a mainly Western perspective. Attention is paid, however, to misunderstandings and conflicts that may arise in today's multicultural societies where values and norms differ. Examples of federal and state law that support patient autonomy and various theories of bioethics deliberation will be given. Guidelines will be provided on steps to analyze situations seen as ethically challenging. A case will be used to illustrate the role of the nurse in the decision-making process in a woman without capacity at end of life.