Skip to main content

2024 | OriginalPaper | Buchkapitel

Moral Distress and the Intrapsychic Hazards of Medical Practice

verfasst von : Daniel T. Kim

Erschienen in: Religion and Social Criticism

Verlag: Springer Nature Switzerland

Aktivieren Sie unsere intelligente Suche, um passende Fachinhalte oder Patente zu finden.

search-config
loading …

Abstract

In this chapter, I will consider Miller’s reading of Augustine on the emotions that should arise in a person who, in pursuing justifiable ends, causes morally undesirable eventualities. Drawing on Miller’s article “Augustine, Moral Luck, and the Ethics of Regret and Shame,” I focus on the concept of what he calls “intrapsychic luck” and argue that it offers a new, further humanizing insight into discourses on moral distress in modern medicine. Moral distress, which was first coined in the nursing literature in 1984, has since gained traction in the wider medical literature, with some now hypothesizing it as a root cause of clinician burnout. I will briefly review this development and re-describe moral distress as a feeling of agent-regret that aptly arises in circumstances of what Miller calls “extrapsychic luck.” On this picture, intrapsychic luck clarifies an added source of moral distress that attends to the self’s anarchic desires. I illustrate this point in terms of the pervasive threats of self-interested careerism and commercialism in modern health care and the clinician’s struggle against self-alienation. I show that this struggle further elucidates moral distress as a deeper problem of professional identity and conclude by considering some practical implications of that insight.

Sie haben noch keine Lizenz? Dann Informieren Sie sich jetzt über unsere Produkte:

Springer Professional "Wirtschaft+Technik"

Online-Abonnement

Mit Springer Professional "Wirtschaft+Technik" erhalten Sie Zugriff auf:

  • über 102.000 Bücher
  • über 537 Zeitschriften

aus folgenden Fachgebieten:

  • Automobil + Motoren
  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Elektrotechnik + Elektronik
  • Energie + Nachhaltigkeit
  • Finance + Banking
  • Management + Führung
  • Marketing + Vertrieb
  • Maschinenbau + Werkstoffe
  • Versicherung + Risiko

Jetzt Wissensvorsprung sichern!

Springer Professional "Wirtschaft"

Online-Abonnement

Mit Springer Professional "Wirtschaft" erhalten Sie Zugriff auf:

  • über 67.000 Bücher
  • über 340 Zeitschriften

aus folgenden Fachgebieten:

  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Finance + Banking
  • Management + Führung
  • Marketing + Vertrieb
  • Versicherung + Risiko




Jetzt Wissensvorsprung sichern!

Fußnoten
1
Jameton shared this skepticism as a peer reviewer for the Hastings Center Report in response to an early draft of the argument on moral distress by me and my colleagues. Jameton self-identified himself as the reviewer.
 
2
See fn. 1 for the reference.
 
3
Others in the medical literature have used the term moral injury instead of moral distress as a description of a root cause of what ails physicians (Talbot and Dean 2018; Dean et al. 2019). This potentially leverages the work that has been done on moral injury with combat veterans (Talbot and Dean 2018). These scholars distinguish moral injury from moral distress, seeing the former as a culmination of repeated experiences of the latter (Dean et al. 2020). But in my view, there are strong parallels between the two constructs. Jameton defines moral distress as (a) the inability to do a perceived right because of (b) institutional constraints (c) in often high-stakes healthcare settings. In parallel, moral injury, which was coined by Jonathan Shay, involves (a) “a betrayal of what’s right,” (b) “by someone who holds legitimate authority,” and (c) “in a high stakes situation” (Shay 2014, 183). Moreover, in the context of clinician burnout, the two concepts are generally deployed to do the same work—to clarify the injuries to one’s agency that may lead to burnout. For that reason, this chapter focuses on moral distress, since that is the term that has a longer history of use among clinicians.
 
4
This insight relies on an important distinction that Miller makes between “luck-as-chance” and “luck-as-fate.” In the former, the luck is utterly random; it is akin to “a lottery.” In the latter, the luck is akin to “a horoscope”; it “refers to reliable patterns in experience that are more or less intractable to human planning” (2020, 370–371). The lorry driver’s situation is that of luck-as-chance, whereas the institutional constraints are matters of luck-as-fate. But Miller’s useful distinction here suggests that both are matters of moral luck insofar as both are beyond the control of the agent. I will say more about this below.
 
5
This is in fact a critical distinction that Judith Wilkinson makes in one of the first qualitative studies of moral distress. Nurses who witness an immoral act, such as the intubation of a dead body, that they are powerless to stop may feel moral outrage. But the difference from moral distress is that the focus of the outrage is someone else’s actions, not their own: the nurses “do not believe they, themselves, have done anything wrong” (1988, 24).
 
6
Williams makes a similar point that this ancient moral ideal of tranquility persists as a powerful strand in moral thought today, with Kant’s categorical imperative as a foremost example. The idea persists because it promises an illusory “solace to a sense of the world’s unfairness” (1976, 115–116)—one that is not in fact attainable.
 
7
This is consonant with survey-based findings in which a majority of clinicians report experiencing moral distress not only as inevitable in fraught medical circumstances but also as reflective of their humanity and compassion toward their patients—as something that should not necessarily be eliminated (Prentice et al. 2018).
 
8
Augustine writes similarly elsewhere that sex involves “a bodily pleasure so great that, at that moment of time when he achieves his climax, the alertness and, so to speak, vigilance of a man’s mind is almost entirely overwhelmed” (1998, XIV.16).
 
9
He marvels, for instance, at “certain barbarians” who “keep their coverings on while they wash” in baths and at Indian gymnosophists who practice philosophy naked but “nevertheless have coverings on their genitals” (XIV.17).
 
10
Influential sociological histories of US health care trace the ways in which physicians have long leveraged their professional authority to serve their own economic or guild interests, at times at the expense of their patients (Starr 1982, 21–28; Berlant 1975, 64–127).
 
11
The issues Pellegrino and Thomasma cite include “whether to disclose one’s HIV-positive status, having an economic interest in an MRI unit to which one refers a patients, whether there is a duty to treat all patients who request care, the problem of healthcare for the poor and one’s obligations in this regard, the reform of the health care system, conflicts about requests or public policy for physician-assisted suicide, integrity in scientific research, the medical-industrial complex, physicians’ incentives as gatekeepers to keep costs down, and many others” (1993, 31). This was 30 years ago, but it is fair to say that the same basic issues persist today.
 
Literatur
Zurück zum Zitat Aristotle. 1962. Nicomachean Ethics. Translated by Martin Ostwald. Library of Liberal Arts. Englewood Cliffs, NJ: Prentice Hall. Aristotle. 1962. Nicomachean Ethics. Translated by Martin Ostwald. Library of Liberal Arts. Englewood Cliffs, NJ: Prentice Hall.
Zurück zum Zitat Augustine. 1998. The City of God against the Pagans. Translated by R.W. Dyson. Cambridge: Cambridge University Press. Augustine. 1998. The City of God against the Pagans. Translated by R.W. Dyson. Cambridge: Cambridge University Press.
Zurück zum Zitat Beauchamp, Tom L., and James F. Childress. 2019. Principles of Biomedical Ethics. 8th ed. New York: Oxford University Press. Beauchamp, Tom L., and James F. Childress. 2019. Principles of Biomedical Ethics. 8th ed. New York: Oxford University Press.
Zurück zum Zitat Berlant, Jeffrey L. 1975. Profession and Monopoly: A Study of Medicine in the United States and Great Britain. University of California Press. Berlant, Jeffrey L. 1975. Profession and Monopoly: A Study of Medicine in the United States and Great Britain. University of California Press.
Zurück zum Zitat Bernat, James L. 2012. “Restoring Medical Professionalism.” Neurology 79 (8): 820-7. Bernat, James L. 2012. “Restoring Medical Professionalism.” Neurology 79 (8): 820-7.
Zurück zum Zitat Berwick, Donald M. 2023. “Salve Lucrum: The Existential Threat of Greed in US Health Care.” Journal of the American Medical Association 329 (8): 629-30. Berwick, Donald M. 2023. “Salve Lucrum: The Existential Threat of Greed in US Health Care.” Journal of the American Medical Association 329 (8): 629-30.
Zurück zum Zitat Biller-Andorno, Nikola, and Thomas H. Lee. 2013. “Ethical Physician Incentives—From Carrots and Sticks to Shared Purpose.” New England Journal of Medicine 368 (11): 980-2. Biller-Andorno, Nikola, and Thomas H. Lee. 2013. “Ethical Physician Incentives—From Carrots and Sticks to Shared Purpose.” New England Journal of Medicine 368 (11): 980-2.
Zurück zum Zitat Bosslet, Gabriel T., Thaddeus M. Pope, Gordon D. Rubenfeld, et al. 2015. “An Official ATS/AACN/ACCP/ESICM/SCCM Policy Statement: Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units.” American Journal of Respiratory and Critical Care Medicine 191 (11): 1318–30. Bosslet, Gabriel T., Thaddeus M. Pope, Gordon D. Rubenfeld, et al. 2015. “An Official ATS/AACN/ACCP/ESICM/SCCM Policy Statement: Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units.” American Journal of Respiratory and Critical Care Medicine 191 (11): 1318–30.
Zurück zum Zitat Campbell, Stephen, Connie Ulrich, and Christine Grady. 2016. “A Broader Understanding of Moral Distress.” American Journal of Bioethics 16 (12): 2-9. Campbell, Stephen, Connie Ulrich, and Christine Grady. 2016. “A Broader Understanding of Moral Distress.” American Journal of Bioethics 16 (12): 2-9.
Zurück zum Zitat Candilis, Philip J., Daniel T. Kim, Lois Snyder Sulmasy, for the ACP Ethics, Professionalism and Human Rights Committee. 2019. “Physician Impairment and Rehabilitation: Reintegration into Medical Practice while Ensuring Patient Safety: A Position Paper from the American College of Physicians.” Annals of Internal Medicine 170 (12): 871-9.CrossRef Candilis, Philip J., Daniel T. Kim, Lois Snyder Sulmasy, for the ACP Ethics, Professionalism and Human Rights Committee. 2019. “Physician Impairment and Rehabilitation: Reintegration into Medical Practice while Ensuring Patient Safety: A Position Paper from the American College of Physicians.” Annals of Internal Medicine 170 (12): 871-9.CrossRef
Zurück zum Zitat Clairmont, David A. 2011. Moral Struggle and Religious Ethics. Malden, MA: Wiley-Blackwell. Clairmont, David A. 2011. Moral Struggle and Religious Ethics. Malden, MA: Wiley-Blackwell.
Zurück zum Zitat Dean, Wendy, Simon Talbot, and Austin Dean. 2019. “Reframing Clinician Distress: Moral Injury Not Burnout,” Federal Practitioner 36 (9): 400-2. Dean, Wendy, Simon Talbot, and Austin Dean. 2019. “Reframing Clinician Distress: Moral Injury Not Burnout,” Federal Practitioner 36 (9): 400-2.
Zurück zum Zitat Dean, Wendy, Simon G. Talbot, and Arthur Caplan. 2020. “Clarifying the Language of Clinician Distress.” Journal of the American Medical Association 323 (10): 923-4. Dean, Wendy, Simon G. Talbot, and Arthur Caplan. 2020. “Clarifying the Language of Clinician Distress.” Journal of the American Medical Association 323 (10): 923-4.
Zurück zum Zitat DeCamp, Matthew, Lois Snyder Sulmasy, for the ACP Ethics, Professionalism and Human Rights Committee. 2021. “Ethical and Professionalism Implications of Physician Employment and Health Care Business Practices: A Policy Paper from the American College of Physicians.” Annals of Internal Medicine 174 (6): 844-51. DeCamp, Matthew, Lois Snyder Sulmasy, for the ACP Ethics, Professionalism and Human Rights Committee. 2021. “Ethical and Professionalism Implications of Physician Employment and Health Care Business Practices: A Policy Paper from the American College of Physicians.” Annals of Internal Medicine 174 (6): 844-51.
Zurück zum Zitat Dzeng, Elizabeth, and Robert M. Wachter. 2020. “Ethics in Conflict: Moral Distress as a Root Cause of Burnout.” Journal of General Internal Medicine 35 (2): 409-11. Dzeng, Elizabeth, and Robert M. Wachter. 2020. “Ethics in Conflict: Moral Distress as a Root Cause of Burnout.” Journal of General Internal Medicine 35 (2): 409-11.
Zurück zum Zitat Elliott, Carl. 2010. White Coat, Black Hat: Adventures on the Dark Side of Medicine. Boston, MA: Beacon Press. Elliott, Carl. 2010. White Coat, Black Hat: Adventures on the Dark Side of Medicine. Boston, MA: Beacon Press.
Zurück zum Zitat Elpern, Ellen H., Barbara Covert, and Ruth Kleinpell. 2005. “Moral Distress of Staff Nurses in a Medical Intensive Care Unit.” American Journal of Critical Care 14 (6): 523-30. Elpern, Ellen H., Barbara Covert, and Ruth Kleinpell. 2005. “Moral Distress of Staff Nurses in a Medical Intensive Care Unit.” American Journal of Critical Care 14 (6): 523-30.
Zurück zum Zitat Epstein, Elizabeth G., and Ann B. Hamric. 2009. “Moral Distress, Moral Residue, and the Crescendo Effect.” Journal of Clinical Ethics 20 (4): 330-42. Epstein, Elizabeth G., and Ann B. Hamric. 2009. “Moral Distress, Moral Residue, and the Crescendo Effect.” Journal of Clinical Ethics 20 (4): 330-42.
Zurück zum Zitat Epstein, Elizabeth G., Ashley R. Hurst, Dea Mahanes, Mary Faith Marshall, and Ann B. Hamric. 2016. “Is Broader Better?” American Journal of Bioethics 16 (12): 15-7. Epstein, Elizabeth G., Ashley R. Hurst, Dea Mahanes, Mary Faith Marshall, and Ann B. Hamric. 2016. “Is Broader Better?” American Journal of Bioethics 16 (12): 15-7.
Zurück zum Zitat Fumis, Renata Rego Lins, Gustavo Adolpho Junqueira Amarante, Andréia de Fátima Nascimento, and José Mauro Vieira Jr. 2017. “Moral Distress and Its Contribution to the Development of Burnout Syndrome among Critical Care Providers.” Annals of Intensive Care 7 (1): 71. Fumis, Renata Rego Lins, Gustavo Adolpho Junqueira Amarante, Andréia de Fátima Nascimento, and José Mauro Vieira Jr. 2017. “Moral Distress and Its Contribution to the Development of Burnout Syndrome among Critical Care Providers.” Annals of Intensive Care 7 (1): 71.
Zurück zum Zitat Hirschman, Albert O. 1970. Exit, Voice, and Loyalty: Responses to Decline in Firms, Organizations, and States. Cambridge, MA: Harvard University Press. Hirschman, Albert O. 1970. Exit, Voice, and Loyalty: Responses to Decline in Firms, Organizations, and States. Cambridge, MA: Harvard University Press.
Zurück zum Zitat Institute of Medicine. 2009. Conflict of Interest in Medical Research, Education, and Practice. Washington, DC: National Academies Press. Institute of Medicine. 2009. Conflict of Interest in Medical Research, Education, and Practice. Washington, DC: National Academies Press.
Zurück zum Zitat Jameton, Andrew. 1984. Nursing Practice: The Ethical Issues. New Jersey: Prentice-Hall. Jameton, Andrew. 1984. Nursing Practice: The Ethical Issues. New Jersey: Prentice-Hall.
Zurück zum Zitat Jameton, Andrew. 2017. “What Moral Distress in Nursing History Could Suggest about the Future of Health Care.” AMA Journal of Ethics 19 (6): 617-28. Jameton, Andrew. 2017. “What Moral Distress in Nursing History Could Suggest about the Future of Health Care.” AMA Journal of Ethics 19 (6): 617-28.
Zurück zum Zitat Johnson-Coyle, Leah, Dawn Opgenorth, Mandy Bellows, et al., 2016. “Moral Distress and Burnout among Cardiovascular Surgery Intensive Care Unit Healthcare Professionals: A Prospective Cross-Sectional Survey.” Canadian Journal of Critical Care Nursing 27 (4): 27-36. Johnson-Coyle, Leah, Dawn Opgenorth, Mandy Bellows, et al., 2016. “Moral Distress and Burnout among Cardiovascular Surgery Intensive Care Unit Healthcare Professionals: A Prospective Cross-Sectional Survey.” Canadian Journal of Critical Care Nursing 27 (4): 27-36.
Zurück zum Zitat Jonsen, Albert R. 1983. “Watching the Doctor.” New England Journal of Medicine 308: 1531-5. Jonsen, Albert R. 1983. “Watching the Doctor.” New England Journal of Medicine 308: 1531-5.
Zurück zum Zitat Lamiani, Giulia, Lidia Borghi, and Piergiorgio Argentero. 2017. “When Healthcare Professionals Cannot Do the Right Thing: A Systematic Review of Moral Distress and Its Correlates.” Journal of Health Psychology 22 (1): 51-67. Lamiani, Giulia, Lidia Borghi, and Piergiorgio Argentero. 2017. “When Healthcare Professionals Cannot Do the Right Thing: A Systematic Review of Moral Distress and Its Correlates.” Journal of Health Psychology 22 (1): 51-67.
Zurück zum Zitat Lantos, John D. 2007. “Moral Distress and Ethical Confrontation: Problem or Progress?” Journal of Perinatology 27 (4): 201-2. Lantos, John D. 2007. “Moral Distress and Ethical Confrontation: Problem or Progress?” Journal of Perinatology 27 (4): 201-2.
Zurück zum Zitat May, William F. 2001. Beleaguered Rulers: The Public Obligation of the Professional. Louisville: Westminster John Knox Press. May, William F. 2001. Beleaguered Rulers: The Public Obligation of the Professional. Louisville: Westminster John Knox Press.
Zurück zum Zitat McCarthy, Joan, and Chris Gastmans. 2015. “Moral Distress: A Review of the Argument-based Nursing Ethics Literature.” Nursing Ethics 22 (1): 131-52. McCarthy, Joan, and Chris Gastmans. 2015. “Moral Distress: A Review of the Argument-based Nursing Ethics Literature.” Nursing Ethics 22 (1): 131-52.
Zurück zum Zitat McCarthy, Joan, and Settimio Monteverde. 2018. “The Standard Account of Moral Distress and Why We Should Keep It.” HEC Forum 30 (1): 319-28. McCarthy, Joan, and Settimio Monteverde. 2018. “The Standard Account of Moral Distress and Why We Should Keep It.” HEC Forum 30 (1): 319-28.
Zurück zum Zitat Miller, Richard B. 2020. “Augustine, Moral Luck, and the Ethics of Regret and Shame.” Journal of Religion 100 (3): 361-385. Miller, Richard B. 2020. “Augustine, Moral Luck, and the Ethics of Regret and Shame.” Journal of Religion 100 (3): 361-385.
Zurück zum Zitat Morris, Herbert. 1976. On Guilt and Innocence: Essays in Legal Philosophy and Moral Psychology. Berkeley, CA: University of California Press. Morris, Herbert. 1976. On Guilt and Innocence: Essays in Legal Philosophy and Moral Psychology. Berkeley, CA: University of California Press.
Zurück zum Zitat National Academy of Medicine. 2019. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. Washington, DC: The National Academies Press. National Academy of Medicine. 2019. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. Washington, DC: The National Academies Press.
Zurück zum Zitat Nguyen, Nguyen X., and Frederick W. Derrick. 1997. “Physician Behavioral Response to a Medicare Price Reduction.” Health Services Research 32(3): 283-98. Nguyen, Nguyen X., and Frederick W. Derrick. 1997. “Physician Behavioral Response to a Medicare Price Reduction.” Health Services Research 32(3): 283-98.
Zurück zum Zitat Ong, Ryan S.R., Ruth S.M. Wong, Ryan C.H. Chee, et al. 2022. “A Systematic Scoping Review Moral Distress Amongst Medical Students.” BMC Medical Education 22: 466. Ong, Ryan S.R., Ruth S.M. Wong, Ryan C.H. Chee, et al. 2022. “A Systematic Scoping Review Moral Distress Amongst Medical Students.” BMC Medical Education 22: 466.
Zurück zum Zitat Parsa-Parsi, Ramin W. 2017. “The Revised Declaration of Geneva: A Modern-Day Physician’s Pledge.” Journal of the American Medical Association 318 (20): 1971-2. Parsa-Parsi, Ramin W. 2017. “The Revised Declaration of Geneva: A Modern-Day Physician’s Pledge.” Journal of the American Medical Association 318 (20): 1971-2.
Zurück zum Zitat Pellegrino, Edmund D. 1990. “The Medical Profession as a Moral Community.” Bulletin of the New York Academy of Medicine 66 (3): 221-32. Pellegrino, Edmund D. 1990. “The Medical Profession as a Moral Community.” Bulletin of the New York Academy of Medicine 66 (3): 221-32.
Zurück zum Zitat Pellegrino, Edmund, and David Thomasma. 1993. The Virtues in Medical Practice. New York: Oxford University Press. Pellegrino, Edmund, and David Thomasma. 1993. The Virtues in Medical Practice. New York: Oxford University Press.
Zurück zum Zitat Prentice, Trisha M., Lynn Gillam, Peter G. Davis, and Annie Janvier. 2018. “Always a Burden? Healthcare Providers’ Perspectives on Moral Distress.” Archives of Disease in Childhood - Fetal and Neonatal Edition 103 (5): F441-5. Prentice, Trisha M., Lynn Gillam, Peter G. Davis, and Annie Janvier. 2018. “Always a Burden? Healthcare Providers’ Perspectives on Moral Distress.” Archives of Disease in Childhood - Fetal and Neonatal Edition 103 (5): F441-5.
Zurück zum Zitat Prentice, Trisha M., Dilini I. Imbulana, Lynn Gillam, et al. 2022. “Addressing Moral Distress: Lessons Learnt from a Non-Interventional Longitudinal Study on Moral Distress.” AJOB Empirical Bioethics 13 (4): 226-36. Prentice, Trisha M., Dilini I. Imbulana, Lynn Gillam, et al. 2022. “Addressing Moral Distress: Lessons Learnt from a Non-Interventional Longitudinal Study on Moral Distress.” AJOB Empirical Bioethics 13 (4): 226-36.
Zurück zum Zitat Rider, Elizabeth A., Suzanne Kurtz, Diana Slade, et al. 2014. “The International Charter for Human Values in Healthcare: An Interprofessional Global Collaboration to Enhance Values and Communication in Healthcare.” Patient Education and Counseling 96 (3): 273–80. Rider, Elizabeth A., Suzanne Kurtz, Diana Slade, et al. 2014. “The International Charter for Human Values in Healthcare: An Interprofessional Global Collaboration to Enhance Values and Communication in Healthcare.” Patient Education and Counseling 96 (3): 273–80.
Zurück zum Zitat Shay, Jonathan. 2014. “Moral Injury.” Psychoanalytic Psychology 31 (2): 182-91. Shay, Jonathan. 2014. “Moral Injury.” Psychoanalytic Psychology 31 (2): 182-91.
Zurück zum Zitat Shelton, Wayne, and Lisa Campo-Engelstein. 2021. “Confronting the Hidden Curriculum: A Four-Year Integrated Course in Ethics and Professionalism Grounded in Virtue Ethics.” Journal of Medical Humanities 42 (4): 689-703. Shelton, Wayne, and Lisa Campo-Engelstein. 2021. “Confronting the Hidden Curriculum: A Four-Year Integrated Course in Ethics and Professionalism Grounded in Virtue Ethics.” Journal of Medical Humanities 42 (4): 689-703.
Zurück zum Zitat Silverman, Stuart I. 2015. “In an Era of Healthcare Delivery Reforms, the Corporate Practice of Medicine is a Matter that Requires Vigilance. Health Law & Policy Brief 9 (1): 1-23. Silverman, Stuart I. 2015. “In an Era of Healthcare Delivery Reforms, the Corporate Practice of Medicine is a Matter that Requires Vigilance. Health Law & Policy Brief 9 (1): 1-23.
Zurück zum Zitat Starr, Paul. 1982. The Social Transformation of American Medicine. New York: Basic Books. Starr, Paul. 1982. The Social Transformation of American Medicine. New York: Basic Books.
Zurück zum Zitat Taylor, Cath, Andreas Xyrichis, Mary C. Leamy, et al. 2018. “Can Schwartz Center Rounds Support Healthcare Staff with Emotional Challenges at Work, and How Do They Compare with Other Interventions Aimed at Providing Similar Support? A Systematic Review and Scoping Reviews.” British Medical Journal Open 8 (10): e024254. Taylor, Cath, Andreas Xyrichis, Mary C. Leamy, et al. 2018. “Can Schwartz Center Rounds Support Healthcare Staff with Emotional Challenges at Work, and How Do They Compare with Other Interventions Aimed at Providing Similar Support? A Systematic Review and Scoping Reviews.” British Medical Journal Open 8 (10): e024254.
Zurück zum Zitat Taylor, Charles. 1985. “What is Human Agency?” In Human Agency and Language: Philosophical Papers 1, 15-44. Cambridge: Cambridge University Press. Taylor, Charles. 1985. “What is Human Agency?” In Human Agency and Language: Philosophical Papers 1, 15-44. Cambridge: Cambridge University Press.
Zurück zum Zitat Wald, Hedy S., Jordan White, Shmuel P. Reis, et al. 2019. “Grappling with Complexity: Medical Students’ Reflective Writings about Challenging Patient Encounters as a Window into Professional Identity Formation.” Medical Teacher 41 (2): 152-60. Wald, Hedy S., Jordan White, Shmuel P. Reis, et al. 2019. “Grappling with Complexity: Medical Students’ Reflective Writings about Challenging Patient Encounters as a Window into Professional Identity Formation.” Medical Teacher 41 (2): 152-60.
Zurück zum Zitat Weise, Kathryn L., Alexander L. Okun, Brian S. Carter, et al. 2017. “Guidance on Forgoing Life-Sustaining Medical Treatment.” Pediatrics. 140 (3): e20171905. Weise, Kathryn L., Alexander L. Okun, Brian S. Carter, et al. 2017. “Guidance on Forgoing Life-Sustaining Medical Treatment.” Pediatrics. 140 (3): e20171905.
Zurück zum Zitat West, Colin P., Liselotte N. Dyrbye, Patricia J. Erwin, and Tait D. Shanafelt. 2016. “Interventions to Prevent and Reduce Physician Burnout: A Systematic Review and Meta-analysis.” The Lancet 388 (10057): 2272-81. West, Colin P., Liselotte N. Dyrbye, Patricia J. Erwin, and Tait D. Shanafelt. 2016. “Interventions to Prevent and Reduce Physician Burnout: A Systematic Review and Meta-analysis.” The Lancet 388 (10057): 2272-81.
Zurück zum Zitat Wilkinson, Judith M. 1988. “Moral Distress in Nursing Practice: Experience and Effect.” Nursing Forum 23 (1): 16-29. Wilkinson, Judith M. 1988. “Moral Distress in Nursing Practice: Experience and Effect.” Nursing Forum 23 (1): 16-29.
Zurück zum Zitat Williams, Bernard. 1976. “Moral Luck.” Proceedings of the Aristotelian Society, Supplementary Volumes 50: 115-35. Williams, Bernard. 1976. “Moral Luck.” Proceedings of the Aristotelian Society, Supplementary Volumes 50: 115-35.
Zurück zum Zitat Wilson, Mark A. 2014. “Moral Grief and Reflective Virtue.” In Virtue and the Moral Life: Theological and Philosophical Perspectives, edited by William Werpehowski and Kathryn Getek Soltis, 57-73. Lexington Books. Wilson, Mark A. 2014. “Moral Grief and Reflective Virtue.” In Virtue and the Moral Life: Theological and Philosophical Perspectives, edited by William Werpehowski and Kathryn Getek Soltis, 57-73. Lexington Books.
Metadaten
Titel
Moral Distress and the Intrapsychic Hazards of Medical Practice
verfasst von
Daniel T. Kim
Copyright-Jahr
2024
DOI
https://doi.org/10.1007/978-3-031-48659-3_7

Premium Partner