Moral distress arises not only from organizational constraints on moral action but also from the environmental impacts of health care and climate change.
AMA J Ethics. 2017;19(6):617-628. doi:
10.1001/journalofethics.2017.19.6.mhst1-1706.
Those charged by the ACA health reform act to identify best clinical practices that are evidence-based and applicable across diverse populations can learn much from the experience of the Medicare-funded End Stage Renal Disease Program.