Addressing Moral Distress During the COVID-19 Pandemic: Insights About Future Directions From Canadian Ethicists and Healthcare Leaders.

Moral distress increased among healthcare workers during the first three years of the COVID-19 pandemic. This qualitative descriptive study explored the experiences of thirteen healthcare professionals with expertise in supporting healthcare workers experiencing moral distress within Canadian healthcare systems during this time. Participants reported multiple factors driving moral distress, such as resource scarcity (e.g., staffing shortages), policies (e.g., vaccination), and sociopolitical issues (e.g., diminishing support for healthcare workers). A range of interventions was employed to address moral distress, including: education, debriefing, consultation, mentorship, and general wellness programs. A strong knowledge of moral distress and counselling skills were both cited as necessary tools for individuals facilitating moral distress interventions. Values central to experiences of moral distress (e.g., transparency, accountability, respect, care) were identified, and participants described factors that could support organizational change to align with these values to better address moral distress (e.g., transparent communication, capacity-building). Finally, participants called for societal and political support for resource allocation to healthcare systems to ensure system sustainability and the ability of healthcare professionals to provide ethically sound care to all members of society.