Purpose/Context.

In intensive care units, actions aim to recover, preserve, or improve patients' lives; however, when life is just being extended under suffering after trying everything, limitation of therapeutic effort (LTE) is considered an alternative for a good death. This article establishes the ethical dilemmas and the nursing interventions in LTE in adult intensive care.

Methodology/Approach.

A critical review of the literature was made in five databases. We obtained 31 articles that met the study selection criteria.

Results/Findings.

Of the integrative analysis, five categories emerged related to ethical dilemmas and nursing interventions in LTE: nursing participation in decision-making, the nurse-patient/family relationship, the limiting factors in implementing LTE, and the search for a good death.

Discussion/Conclusions/Contributions.

Nursing makes far-reaching interventions at the end of the critical patient's life cycle; nevertheless, their participation in the process is still invisible. Nursing professionals need to acquire skills and knowledge of empathic communication, ethics, and the fundamentals of end-of-life care to guide comprehensive health care in the LTE process.

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