AMA Journal of Ethics. June 2017
This month in Journal of Ethics
Moral Distress and Medicine
What happens when students and clinicians feel a conflict between their deeply held values and the demands of an event unfolding before them—and feel powerless to intervene? Research about this set of experiences, first documented years ago in nurses as moral distress, has evolved in important ways and has now been prominently explored in other health professions’ ethics literatures. Medical students and resident physicians are particularly vulnerable to moral distress, given the hierarchical nature of their training. This month’s issue of the AMA Journal of Ethics distinguishes different types of moral distress and considers how clinicians, organizations, and educators can identify and acknowledge moral distress and respond with care for patients and for each other.
How Should Integrity Preservation and Professional Growth Be Balanced during Trainees’ Professionalization? Commentary by Eli Weber, PhD, MA, and Sharon Gray, BSN, PHN, RN Ethics education can prompt reconsideration of beliefs that lead to moral distress.
What Is the Role of Ethics Consultation in the Moral Habitability of Health Care Environments? Wendy Austin, PhD, RN Interdisciplinary ethics consultation helps address organizational policies, practices, and structures that can be sources of moral distress.
How Should Physicians Respond When the Best Treatment for an Individual Patient Conflicts with Practice Guidelines about the Use of a Limited Resource? Commentary by Edmund G. Howe III, MD, JD When patient-centered care conflicts with duties to follow guidelines, physicians should be transparent with patients.
Strategies for Promoting High-Quality Care and Personal Resilience in Palliative Care Katherine E. Heinze, PhD, RN, Heidi K. Holtz, PhD, RN, and Cynda H. Rushton, PhD, RN Incorporate palliative care ethics into research, education, practice, and systems design to reduce moral distress.
July Quality of Life in Dementia
August Iatrogenesis in Pediatrics
September Incarceration and Correctional Health Care
October Clean Water Access and the Roles of Clinicians
November Ethics of Collaborative Health Systems Design
December Health Care Ethics and Professionalism in the Era of Climate Change
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