When doctors and nurses can't do the right thing

Moral distress is defined as knowing what is ethically appropriate but being unable to act on it because of obstacles inherent in a situation. Researchers focused primarily on the experiences of nurses have found that those who suffered from moral distress often became reluctant to interact with patients and other providers. In one recent study, 15% of nurses left their jobs because of moral distress. It now appears that doctors—caught between obligations to patients and the demands of insurance companies, administrators and even, occasionally, patients' families—are feeling increasingly "trapped" and unable to do what they believe is ethically right, according to this column from Pauline W. Chen, MD, in the New York Times.