School of Nursing, Pellegrino Center of Clinical Bioethics and Georgetown University Medical Center, Washington, DC, USA.
Internal Medicine, Pellegrino Center of Clinical Bioethics and Georgetown University Medical Center, Washington, DC, USA.
HEC Forum. 2021 Dec;33(4):415-423. doi: 10.1007/s10730-021-09450-y. Epub 2021 Mar 28.
Moral distress is defined as the inability to act according to one's own core values. During the COVID-19 pandemic, moral distress in medical personnel has gained attention, related to the impact of pandemic-associated factors, such as the uncertainty of treatment options for the virus and the accelerated pace of deaths. Measures to provide aid and mitigate the long-term pandemic effect on providers are starting to be designed. Yet, little has been said about the moral distress experienced by patients and the relational and additive effect on provider moral distress. Pandemic-associated factors affecting moral distress in patients include the constraining effects of isolation on spiritual and religious traditions as well as the intentional separation of patients from their families. This paper will explore the idea that patients are suffering their own moral distress and further how this impacts the intensity of moral distress experienced by the providers-nurses and physicians. The paucity of research in this area with the implications on patient's distress, decision making, and distress experienced by providers compels further investigation and analysis.
道德困境是指无法按照自己的核心价值观行事。在 COVID-19 大流行期间，医务人员的道德困境引起了关注，这与大流行相关因素的影响有关，例如治疗病毒的选择不确定以及死亡速度加快。开始设计提供援助和减轻大流行对提供者的长期影响的措施。然而，关于患者所经历的道德困境以及对提供者道德困境的关系和附加影响，几乎没有什么说法。大流行相关因素影响患者的道德困境，包括隔离对精神和宗教传统的限制影响，以及故意将患者与其家人分开。本文将探讨这样一种观点，即患者正在遭受自己的道德困境，以及这如何影响提供者——护士和医生所经历的道德困境的强度。该领域研究的匮乏以及对患者的痛苦、决策和提供者所经历的痛苦的影响，迫使我们进行进一步的调查和分析。
