Moral Distress of Physicians Who Care for Older Adults

A study in the Journal of General Internal Medicine sheds light on moral distress among physicians caring for older adults, reports ScienceDaily . Moral distress is the sense that one's professional integrity has been compromised, because the doctor feels held back from acting on deeply held beliefs. The researchers estimated that 42 percent of doctors caring for older adults who need a surrogate decision-maker experienced moral distress. When working with surrogate decision-makers like family members of the people in their care, physicians often confront ethical dilemmas — like whether to continue life support or not — that may cause moral distress with their potential negative consequences. The researchers determined that moral distress occurred more frequently among male doctors, interns, or other junior-level physicians. The condition also was common when the patient was older, or when decisions were required about life-sustaining treatments. Meanwhile, physicians were less likely to experience moral distress when caring for nursing home residents, or when the physician or family members had discussed care preferences with the person before they were unable to make their own decisions. Moral distress also was less frequent when the surrogate decision-maker felt emotionally supported by the physician and other clinicians, and when doctor and surrogate decision-maker agreed on the course of treatment.