Beth Epstein

Beth Epstein, PhD, RN, HEC-C, FAAN


Beth Epstein is a co-investigator with the research project on rural and urban clinician well-being. In this role, she will provide input related to the moral distress and nursing staff aspects of the study. She will assist in conducting focus groups and contextual inquiry with clinicians, especially at the rural hospitals, and will be part of the data analyses. Dr. Epstein is an Associate Professor and Associate Dean of Academic Programs in the School of Nursing at the University of Virginia (UVA). She is recognized nationally and internationally for her work in bioethics, particularly moral distress. She teaches ethics and pharmacology in the School of Nursing, is a core member of the Center for Health Humanities and Ethics, and is an affiliate faculty member of the UVA Jewish Studies Department. Dr. Epstein directs the UVA Health System’s moral distress consult service, a hospital-wide intervention to address moral distress and is a member of the ethics consult service. Along with colleagues from 6 healthcare organizations across the country, she launched the Moral Distress Consultation Collaborative in 2020 with the purpose of furthering research in moral distress and ethics and developing best practices for moral distress consultation.

Research Focus

End-of-life issues, ethics, pediatrics.

Recent Grants

  • A Precursor for Analysis of Continuity of Care and Ethical Conflict at the End-of-Life, Principal Investigator (2008-2009)

Teaching Focus

Ethics, pharmacology.


Journal Articles

Epstein, E. G., Hurst, A. R., Bourne, D. & Marshall, M. F. (2023). Measure for measure: Condemning the actor and not the fault. The American Journal of Bioethics, 23(4), 66-68.

Bourne, D.W., Epstein, E. (2023). The experience of moral distress in an academic family medicine clinic. HEC Forum, 35(1), 37-54.

Wilson, M. A., Simmons, A., Harris, J. I., Thomas, S., Shay, A., Usset, T. J., Cook, W., Bevington, D., Hurley, A. C., & Epstein, E. (2022). Adaptation and testing of a military version of the measure of moral distress for healthcare professionals. American Journal of Critical Care, 31(5), .

Amos, V. K. and Epstein, E. G. (2022). Moral distress interventions: An integrative literature review. Nursing Ethics, 29(3), 582-607.

Epstein, E., Shah, R., & Marshall, M. F. (2021). Effect of a moral distress consultation service on moral distress, empowerment, and a healthy work environment. Healthcare Ethics Committee Forum, 4(3), 1-15.

Prompahakul, C., Malpass, J., LeBaron, V., Yan, G., & Epstein, B. (2021). Moral distress among nurses: A mixed methods study. Nursing Ethics, 28(8), 1165-1182.

Whitehead, P. B., Carter, K., Garber, J., & Epstein, E. G. (2021). The nurse manager’s experience of moral distress. Journal of Nursing Administration, 51(6), 334-339.

Epstein, E. G. (2021). A closer look at feticide and moral distress. [Invited commentary]. Journal of Clinical Ethics, 32(2), 124-126.

Prompahakul, C., & Epstein, E.G. (2020). Moral distress experienced by non-Western nurses: An integrative review. Nursing Ethics, 27(3), 778-795.

Epstein, E. G., Haizlip, J., Liaschenko, J., Zhao, D., Bennett, R., & Marshall, M. F. (2020). Moral distress, mattering, and secondary traumatic stress in provider burnout: A call for moral community. AACN Advanced Critical Care, 31(2), 146-157.

Berger, J., Hamric, A. B., & Epstein, E. G. (2019). Self-inflicted moral distress: Opportunity for a fuller exercise of professionalism. Journal of Clinical Ethics, 30(4), 315-318.

Epstein, E. G., Prompahakul, C., Thacker, L., Whitehead, P. B., & Hamric, A. B. (2019). Enhancing understanding of moral distress: The measure of moral distress for healthcare professionals. AJOB Empirical Bioethics, 10(2), 113-124.

Wolf, A., White, K. R., Epstein, E., & Enfield, K. (2019). Palliative care and moral distress: An institutional survey of critical care nurses. Critical Care Nurse, 39(5), 38-49.

Epstein, E., Phyllis, B. W., Prompahakul, C., Leroy, R. T., & Hamric, A. B. (2019). Enhancing understanding of moral distress: The measure of moral distress for health care professionals. AJOB Empirical Bioethics, 10(2), 113-124.

Chen, D., Epstein, E., Almarode, S., Winter, J., & Marshall, M. F. (2018). What the “F”? American Journal of Bioethics, 18(1), 16-19.

Caspari, L., Blackman A., Epstein, E.G., & Kaufman D. (2017). Human factors related to time dependent infection control measures: “Scrub the hub” for venous catheters and feeding tubes. American Journal of Infection Control, 45, 641-651.

Epstein, E., Arechiga, J., Dancy, M., Simon, J., Wilson, D. & Alhusen, J. (2017). Integrative review of technology to support communication with parents of infants in the NICU. Journal of Obstetric, Gynecologic & Neonatal Nursing, 46(3), 357-366.

Epstein, E., & Hurst, A. (2017). Looking at the positive side of moral distress: Why it’s a problem. The Journal of Clinical Ethics, 28(1), 37-41.

Epstein, E. G., Hurst, A. R., Mahanes, D., Marshall, M. F., & Hamric, A. B. (2016). Is broader better? American Journal of Bioethics, 16(12), 15-17.

Alhusen, J., Bower, K., Epstein, E., & Sharps, P. (2016). Racial discrimination and adverse birth outcomes: An integrative review. Journal of Midwifery & Women’s Health, 61(6), 707-720.

Epstein, E.G. & Wolfe, K. (2016). A preliminary evaluation of trust and shared decision making among intensive care unit patients’ family members. Applied Nursing Research, 32, 286-288.

Marshall, M.F. & Epstein, E.G. (2016). Moral hazard and moral distress: A marriage made in purgatory. [Open peer commentary]. American Journal of Bioethics, 16(7), 46-48.

Roczen, M.L., White, K.R., & Epstein, E.G. (2016). Palliative care and intensive care units: A systematic review. Journal of Hospice and Palliative Nursing, 18(3), 201-211.

Whitehead, P., Herbertson, R.K., Hamric, A.B., Epstein, E.G., & Fisher, J.M. (2015). Moral distress among healthcare professionals: Report of an institution-wide survey. Journal of Nursing Scholarship, 47(2), 117-125.

Epstein, E.G. & Turner, M. (2015). The nursing code of ethics: Its value, its history. Online Journal of Issues in Nursing, 20(2), 4.

Trautmann, J., Epstein, E., Rovnyak, V., Snyder, A. (2015). Relationships among moral distress, level of practice independence, and intent to leave of nurse practitioners in emergency departments: results from a national survey. Advanced Emergency Nursing Journal, 37(2), 134-45.

Epstein, E. G., Sherman, J., Blackman, A., & Sinkin, R. A. (2015). Testing the feasibility of Skype and FaceTime updates with parents in the NICU. American Journal of Critical Care, 24(4), 290-296.

Epstein, E.G., Rovnyak, V., Miles, A. & Baernholdt, M. (2013). Parents’ perceptions of continuity of care in the NICU: Preliminary testing of an instrument and implications for the nurse-parent relationship. Journal of Perinatal and Neonatal Nursing, 27(2), 168-175.

Hamric, A.B., Borchers, C.T., & Epstein, E.G. (2012). Development and testing of an instrument to measure moral distress in healthcare professionals. AJOB Primary Research, (2), 1-9.

Hamric, A.B., Borchers, C.T., & Epstein, E.G. (2012). Development and testing of an instrument to measure moral distress. AJOB Primary Research, 3(2), 1-9.

Epstein, E.G. (2012). Preventive ethics in the ICU. AACN Advanced Critical Care, 23(2), 217-224.

Epstein, E.G. & Delgado, S.H. (2010). Understanding and addressing moral distress. Online Journal of Issues in Nursing, 15(3), .

Epstein,E. G. (2008). End-of-life experiences of nurses and physicians in the newborn intensive care unit.. Journal of Perinatology, 28(11), 771-778.

Book Sections

Epstein, E. G., & Maynard, F. R. (2020). Ethical dimensions of nursing and health care. In E. E. Friberg (Ed.), Conceptual foundations: The bridge to professional nursing practice (7th ed., pp. 210-224). Elsevier, Inc.

Hamric, A. B., Epstein, E. G., & White, K. R. (2013). Moral distress and the healthcare organization. In G. Filerman, A. Mills, & P. Schyve (Eds.), Managerial ethics in healthcare: A new perspective (pp. 137-57). Health Administration Press.

Epstein, E. G. (2012). Ethical issues in neonatal nursing. In C. M. Ulrich (Ed.), Nursing ethics in everyday practice: A step by step guide (pp. ). Sigma Theta Tau International

Hamric, A.B., Epstein, E.G. & White, K. (2012). Moral distress and the hospital. In A. Mills, G. Filerman, & P. Werhane (Eds.), Healthcare Ethics for Healthcare Organizations: A Moral Imperative (pp. ). Health Administration Press.

Columns, Editorials and Op-Eds

Phillips, E.K., & Epstein, E. G. (2015, January 29). Kavod v’Nichum: Nurses, the dying, and the newly dead. Jewish Journal: Expired and Inspired. Retrieved from