When Fulfilling a Professional Obligation Causes Moral Distress: A New Evaluative Approach

Area of Science:

• Medical Ethics
• Critical Care Medicine
• Professional Identity

Background:

• Moral distress arises when clinicians face institutional constraints preventing them from acting on their ethical judgments.
• This phenomenon is particularly relevant in critical care settings.

Purpose of the Study:

• To explore moral distress in critical care, considering both institutional and ethical reasoning constraints.
• To propose an evaluative approach to moral distress and its impact on professional identity.

Main Methods:

• Selective literature review.
• Analysis of paradigmatic cases of moral distress, such as performing potentially futile procedures.

Main Results:

• Moral distress in physicians stems from workplace culture, resource limitations, and the boundaries of ethical reasoning.
• An emotion-based evaluative framework is necessary to mitigate risks to professional identity.

Conclusions:

• A novel evaluative approach to moral distress is proposed, emphasizing its impact on professional identity.
• Highlights the need for institutional education and support systems for clinicians experiencing moral distress.