When duty to care causes collective sorrow and shame: assessing and addressing moral distress in intensive care unit clinicians

Excerpt

Moral distress is the psychological suffering experienced by individuals who feel constrained, often by institutional or hierarchical pressures, to act in ways that are contrary to their core values. ¹ Moral distress is common in healthcare and is a potential mediator of compassion fatigue, decreased job satisfaction, and clinician burnout, ^2,3 the latter characterized by emotional exhaustion, depersonalization, and reduced professional efficacy. ⁴ The Canadian Medical Association describes four elements that are common in moral distress: 1) feeling that one is complicit in wrongdoing, 2) the belief that one has insight and knowledge relevant to the situation but these are not heard, 3) the belief that the standards in one’s profession are impossible to carry out, and 4) moral residue, in which repeated experiences of moral distress heighten an individual’s distress in subsequent occurrences. ⁵ …