by Berger, Jeffrey T
Journal of General Internal Medicine, Volume 29, Issue 2
Moral distress is the experience of cognitive-emotional dissonance that arises when one feels compelled to act contrary to one’s moral requirements. Moral distress is common, but under-recognized in medical education and training, and this relative inattention may undermine educators’ efforts to promote empathy, ethical practice, and professionalism. Moral distress should be recognized as a feature of the clinical landscape, and addressed in conjunction with the related concerns of negative role modeling and the goals and efficacy of medical ethics curricula.
Moral distress is the cognitive-emotional dissonance that arises when one feels compelled to act against one’s moral requirements. Moral distress is common in clinical practice, because caring for the ill is an inherently moral activity. Medical students and junior practitioners may be particularly challenged by morally distressing situations. Their development into attending physicians involves a process that is complex intellectually, sociologically, and culturally, and is no less complex in its moral dimensions.
Academic health institutions whose leadership presupposes that moral distress affects all of its clinicians will be best positioned to mitigate this stress and to promote moral wellness and professionalism. Programs should expect that their trainees will experience moral distress and trainees should be aware of this expectation.
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