Article
Education, Scientific Disciplines
Colleen M. Farrell, Bradley J. Hayward
Summary: The ongoing COVID-19 pandemic has led to various ethical dilemmas for resident and fellow physician trainees. Based on their own experiences in New York City, the authors discuss common ethical dilemmas faced by trainees during the pandemic, including personal health risk, resource allocation, healthcare inequities, and media relations.
Article
Ethics
Linda Keilman, Soudabeh Jolaei, Douglas P. Olsen
Summary: This study investigated whether US nurses provide care for patients who forgo treatment due to cost and if this results in moral distress. The results showed that most nurses do care for these patients, and it does cause ethical dilemmas. The study also identified the broken US healthcare system as a contributing factor to this phenomenon.
Article
Multidisciplinary Sciences
Nihal Taskiran, Gulengun Turk
Summary: This research aims to determine the relationship between intensive care nurses' ethical attitudes and holistic competence levels. The study found that holistic nursing competence scores were relatively high, while ethical attitude scores were lower, and there was a weak negative correlation between holistic competence levels and ethical attitudes.
Article
Health Care Sciences & Services
Sarah Rosenwohl-Mack, Daniel Dohan, Thea Matthews, Jason Neil Batten, Elizabeth Dzeng
Summary: The study compared moral distress experiences of physician trainees in end-of-life care in the US and the UK, finding similarities in some drivers of moral distress, as well as differences such as healthcare team hierarchies. The research highlights how different healthcare cultures in the US and UK influence physician trainees' experiences of moral distress.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2021)
Article
Ethics
Elvira Luana De Brasi, Noemi Giannetta, Sara Ercolani, Elena Lucia Maria Gandini, Dina Moranda, Giulia Villa, Duilio Fiorenzo Manara
Summary: The study identified the main causes, feelings, and coping strategies of morally distressing events experienced by nurses, as well as varying opinions on the usefulness of palliative care education. Recommendations were made for strengthening existing courses to help nurses cope with moral distress.
Article
Nursing
Zeinab Rezaei, Monirsadat Nematollahi, Neda Asadi
Summary: This study investigated the relationship between moral distress, ethical climate, and attitudes towards end-of-life care among nurses in neonatal intensive care units. The results showed that the nurses had positive perceptions of the ethical climate and favorable attitudes towards end-of-life care. The study suggests the need for strategies to improve the ethical climate in hospitals and reduce moral distress among nurses.
Article
Anesthesiology
Anne L. Dalle Ave, Daniel P. Sulmasy
Summary: Most hospitalized patients die following a decision to forgo life-sustaining treatment and/or focus on comfort care. To help healthcare professionals better understand their own ethical perspectives regarding end-of-life practices, an ethical framework is proposed. This framework identifies three broad ethical perspectives and can help mitigate moral distress among healthcare professionals.
ANAESTHESIA CRITICAL CARE & PAIN MEDICINE
(2023)
Article
Nursing
Anna Falco-Pegueroles, Alejandro Bosch-Alcaraz, Stefano Terzoni, Francesco Fanari, Elena Viola, Gemma Via-Clavero, Sara Gonzalez-Del Hoyo, Anna Maria Parini, Silvia Poveda-Moral, Mauro Parozzi, Joan Guardia-Olmos, Loris Bonetti
Summary: The aim of this study was to explore the sources of ethical conflicts and decision-making processes of ICU nurses and physicians during the COVID-19 pandemic. In-depth interviews were conducted with critical care professionals, and the main sources of ethical conflict were identified as end-of-life care and the lack of humanization and care resources. Further education and training on end-of-life and post-mortem care, effective communication techniques, and bioethical decision-making models are recommended.
JOURNAL OF CLINICAL NURSING
(2023)
Review
Pediatrics
Lilijana Kornhauser Cerar, Miha Lucovnik
Summary: Advances in neonatal care have allowed for survival of extremely premature neonates, but they often face long-term neurodevelopmental challenges. Ethics play a crucial role in managing births at borderline viability. The decision to intervene or not varies based on gestational age, with survival rates increasing and disability rates decreasing after 24 weeks. Parental autonomy should be respected in these decisions, and multidisciplinary collaboration is vital for optimal counseling.
Article
Ethics
Dorothy James Moore, Denise Dawkins, Michelle DeCoux Hampton, Susan McNiesh
Summary: This study examined the multiple pressures faced by critical care nurses during the COVID-19 pandemic and revealed various ethical challenges and decision points. Nurses experienced fear of becoming ill or bringing the disease home, while also adapting to policy changes and challenges in care protocols. They struggled with moral distress when unable to advocate fully for their patients.
Article
Social Sciences, Interdisciplinary
Vera Martins, Cristina Santos, Miguel Ricou, Patricia Bataglia, Ivone Duarte
Summary: This study investigated whether medical students would change their opinions on three ethical dilemmas after completing a Bioethics and Professional Deontology course. The results suggest that students showed less indecision and more agreement or disagreement with the dilemma characters after the course. Bioethics education is important in promoting critical judgment and decision-making skills among medical students.
Article
Health Care Sciences & Services
Katherine Guttmann, John Flibotte, Holli Seitz, Matthew Huber, Sara B. DeMauro
Summary: This study investigated the relationship between quality of Goals of Care (GOC) conversations and moral distress among neonatal intensive care unit (NICU) providers. The findings showed that most providers experienced an increase in moral distress following GOC discussions, and that different elements of discussions and provider roles had varying effects on moral distress levels.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2021)
Article
Critical Care Medicine
Shahla Siddiqui, Wei Wei Zhang, Katharina Platzbecker, Molly J. Douglas, Laura K. Rock, Matthias Eikermann
Summary: Clinicians in the surgical intensive care unit should be prepared for controversial goals of care discussions, as differing opinions often exist between providers of different disciplines. Outcome predictions by healthcare providers are often influenced by their own perspectives and values, rather than reliable scientific evaluation. Providers should approach goals-of-care discussions in a structured, interprofessional manner.
JOURNAL OF CRITICAL CARE
(2021)
Article
Nursing
Paivi Ventovaara, Margareta af Sandeberg, Gitte Petersen, Klas Blomgren, Pernilla Pergert
Summary: This study assessed experiences of morally distressing situations and perceptions of ethical climate in paediatric oncology care. The results showed that nurses perceived morally distressing situations as relatively uncommon, except for those related to time shortage, poor continuity of care, and unsafe staffing levels. Most nurses found it disturbing to perform procedures on school-aged children against their will, and a significant portion reported doing so often. Perceptions of ethical climate were positive, with healthcare professionals being perceived as attentive to children's wishes.
Article
Psychology, Multidisciplinary
Rachel A. Plouffe, Anthony Nazarov, Ann M. Heesters, Chandlee C. Dickey, Laura Foxcroft, Fardous Hosseiny, Tri Le, P. Andrea Lum, Maede S. Nouri, Patrick Smith, J. Don Richardson
Summary: This study longitudinally evaluated the relationship between leadership, workplace support, ethical work environment, and moral distress among Canadian healthcare workers. The findings demonstrate that workplace support and perceptions of an ethical work environment fully mediate the associations between both organizational and supervisory leadership and moral distress. Therefore, providing adequate workplace support and an ethical work environment is crucial for ensuring the well-being and quality of care for healthcare workers.
FRONTIERS IN PSYCHOLOGY
(2023)