Analysis of the role nurses and ethical evaluation in thedecisions taken for care in intensive care units in the COVID-19 process

The rapid increase in the number of daily cases at various stages of the fight against the Covid-19 pandemic in our country was reflected in the number of patients in hospitals and negatively affected the treatment and care of patients in hospital polyclinics, wards, and intensive care units. One of the most significant factors of this negative impact is the restriction of time allocated to the patient due to limited resources. In addition to reducing the time allocated for medical history taking, this situation negatively affected the involvement of the patient in the decision-making process, the consideration of the patient's system of value in these decisions, the quality of communication with the relatives of the patient and the practical actualization of the principle of self-determination/autonomy. In this situation specific to Covid-19, a different feature of intensive care nurses has emerged. Since nurses have the opportunity to frequently observe and evaluate patients due to their professional duties and responsibilities, they undertake an important task in learning the approach of patients regarding care and treatment, their desires and wishes, and communicating with their relatives. This feature, which is already present in intensive care units, has gained greater importance with an ethical dimension, specifically in the Covid-19 Pandemic. The aim of this master's study is to identify and analyze the current role of nurses in decisions with ethical dimensions in the intensive care units in general and in the intensive care units reserved for Covid-19 patients in particular, within the scope of the problem described above. In accordance with this purpose, firstly, questions on the subject were prepared within the framework of a questionnaire study with an quantitative method, and 240 intensive care nurses, who are considered to have the capacity to represent the views of intensive care nurses throughout Turkey according to the sampling analysis, were asked online via personal e-mail, to individuals in intensive care nurse groups in Telegram and WhatsApp applications. This research is a first in Turkey regarding Covid-19 and provides important data on the subject. The study did not only remain at the quantitative research level, but the obtained results were evaluated normatively in the context of the theory of care ethics, one of the most important ethical theories in the field of nursing. The results obtained from the questionnaire were analyzed especially in the scope of self-determination. On the other hand, moral distress, which has an important place in recent medical ethics discussions, was questioned within the framework of the questionnaire and discussed in the discussion section of the study. After ethically analyzing and normatively evaluating these ethically important research results, some important recommendations are made at the end of the study to understand, comprehend, and solve these important ethical problems.