AMA Journal of Ethics theme editor Subha Perni, MD, a recent graduate of the Columbia University College of Physicians and Surgeons, interviewed Elizabeth Epstein, PhD, RN, about strategies for understanding and address moral distress in clinical settings.
When the patient delivers a low-birth-weight infant that requires extensive time in the neonatal intensive, should she be held responsible? Where do we draw the line? More importantly, on what basis do we draw the line?
The advent of force-feeding in the new century in the context of conflict and protest made it necessary to clarify and revise the whole concept of artificial feeding and force-feeding.
At their best, good systems allow space for the practical judgment of health care professionals to achieve justice in the particular actions of their daily practice.
There is no morally compelling reason to distinguish a doctor from a tank driver on the battlefield except for the fact that both sides agree to protect medical personnel.
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.