Nurses in the Western world have given considerable attention to the concepts of vulnerability and self-autonomy in recent decades.

A qualitative study was conducted with nurses to analyze the problems found by health care professionals in their ethical practices when providing care to patients with terminal diseases, in particular concerning aspects of self-autonomy and vulnerability, in respect to those patients and health care providers.

Using bioethics approach, an analysis of the context was carried out to apply a rigorous methodology in this studied area and fundamental concepts in ethical practices that are intermix. We recruited a purposive sample of research participants from among nurses who worked at a hospital located in the middle part of Portugal.

The transcribed interviews of 8 nurses were analyzed. The results identify the types of difficulty with ethical nuances, found by health care providers, in which constitutes a challenge to ethical practices. The interviewed nurses emphasized the need to broaden the arguments about this subject with other health care professionals faced with these cultural changes and ethical paradigms.

The staff's ethical reasoning mainly concerned their experience of a gap between their personal ideals of what a dignified end of life should include and what they were able to provide in reality, which could result in conscious stress. Staff members need training and support. End of life care demands competence and teamwork.