What is moral distress?
Ethical dilemmas are a part of healthcare, as uncertainty about which path to take among possible “right” paths is common in complex medical situations. But what happens when we do know the right action to take but cannot take it? When a man with sickle cell disease does not receive adequate pain control due to a clinician’s biased belief that he is drug seeking? When a homeless man with chest pain in the emergency department is not attended to for hours because he has been labelled as a “frequent flyer”? When doctors and nurses are pressured to continue certain treatments—not because they’re appropriate but because there’s fear of litigation? These situations are morally distressing, that is, they are situations in which clinicians believe they know the right action to take but are constrained from taking that action.
Healthcare organization leaders, clinical ethics consultants, and others are recognizing the impact of moral distress on clinicians. Interventions to address morally distressing situations are developing, one of which is moral distress collaborative consultation (MDCC).
What is a moral distress consult?
The purpose of MDC is to assist healthcare providers experiencing moral distress through facilitated discussion and identification of strategies to overcome barriers to taking appropriate action. The root causes of moral distress often expand beyond the scope of the patient level to that of the unit and system levels of the hospital. So, while the MDC may provide assistance in patient ethical dilemmas, another important goal is assisting staff in identifying and addressing problems at the unit and/or system level such as poor team communication, inefficient unit routines, and ineffective institutional protocols that arise repeatedly and impact patient care negatively.
If you would like to be part of this collaborative or would like more information, please contact Beth Epstein (firstname.lastname@example.org) or Charlene Kaufman (email@example.com).