The Internet has brought the spirit of global communication and collaboration to nurses and other healthcare professionals in ways never before thought possible. These resources are offered to expand your opportunities for discussion, reference, education, and research.

A software vendor told me he really liked having nurses on his team because of their clinical knowledge and credibility with customers. He continued to say nurses generally made lousy salespeople because their discipline required them to be right most if not all of the time. A salesman who was "right" (made the sale) 50% of the time was very successful. He did not think healthcare professionals would tolerate being "right" only half the time.

We deal with life-and-death decisions and often the choices are not crystal clear. What forms our clinical judgment to make the "right" decisions when it comes to withholding life support systems or treatments? How does the legal system view such decisions? How can religious belief systems influence the acceptance or rejection of such recommendations?

The National Institutes of Health Bioethics Resources on the Web (http://www.nih.gov/sigs/bioethics/) is a directory of dozens of sites dealing with NIH programs, general bioethics resources on the Web, and a specific-topics area that is subdivided into Research Ethics, Genetics, Medicine, and Healthcare.

In 2003, the Agency for Healthcare Policy and Research published "Advance Care Planning Preferences for Care at the End of Life" (http://www.ahrq.gov/research/endliferia/endria.htm). "Research can help physicians and other health care professionals guide patient decisionmaking for care at the end of life. Findings resulting from research funded by the Agency for Healthcare Research and Quality (AHRQ) are discussed. This research can help providers offer end-of-life care based on preferences held by the majority of patients under similar circumstances."

A section on medical ethics tutorials links to "Standardized Patient Scenarios for Teaching and Evaluating Bioethics" (http://wings.buffalo.edu/faculty/research/bioethics/osce.html). The scenarios posted at this site will give fodder for many a class discussion. There is also a link to the American Medical Association Virtual Mentor, which is the ethics journal of the AMA located at http://www.ama-assn.org/ama/pub/category/3040.html. It is described on the Web site as "an interactive, Web-based forum for analysis and discussion of ethical and professional issues that medical students encounter during their educational training. The Virtual Mentor content areas are designed to inform, awaken, and energize students to engage in a learning dialogue with experts in medicine, law, and bioethics."

Belief systems are a powerful factor in the acceptance or rejection of recommendations concerning terminating life-sustaining treatments or medications. The Vatican (http://www.vatican.va/) Web site is the authoritative source for Roman Catholic beliefs. This site is somewhat difficult to search but it articulates the teachings received by many who may be in personal conflict between recommendations by healthcare professionals and clergy. Belief Net (http://beliefnet.org/) looks at many world religions and aims to explain the basic beliefs and practices of each faith.

Broaching end-of-life issues, advanced directives and medical power of attorney can be difficult for both providers as well as patients. The American Association of Retired Persons Web site (http://www.aarp.org/life/endoflife/) has an "End of Life" section with resources for both healthcare professionals and consumers. The writing is clear and easy to understand, with many links for further investigation.

Contributed by

William Perry MA, RN