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Moral Distress in Rehabilitation Professionals: Results From a Hospital Ethics Survey
Author(s) -
Mukherjee Debjani,
Brashler Rebecca,
Savage Teresa A.,
Kirschner Kristi L.
Publication year - 2009
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2009.03.004
Subject(s) - confidentiality , rehabilitation , reimbursement , health care , medicine , nursing , focus group , professional ethics , work (physics) , psychology , engineering ethics , sociology , political science , anthropology , law , physical therapy , mechanical engineering , engineering
Objective Moral distress in the rehabilitation setting was examined in a follow‐up survey. The survey had 3 goals: (1) to systematically and anonymously gather data about the ethical issues that employees struggle with in their daily work; (2) to raise the visibility of the hospital‐based ethics program and resources available to employees; and (3) to prioritize and focus the direction of the program's educational seminars, quality improvement projects, and ethics consultation. Design Online survey of employees. Setting Urban rehabilitation system of care. Participants The survey was open to all employees; 207 completed the survey. Interventions N/A Main Outcome Measurements N/A Conclusions Three broad categories of moral distress were identified: institutional ethics, professional practice, and clinical decision‐making. Institutional ethics issues related to the health care environment, such as health care reimbursement pressures and corporate culture. Professional practice issues involved codes of behavior and concepts of professionalism, including patient confidentiality/privacy. Clinical decision‐making included such practical dilemmas as conflicts around goal‐setting, discharge planning, and assessment of decision‐making capacity. An anonymous survey of staff members allowed the hospital ethics program to identify sources of moral distress and prioritize strategies to address them.