The ongoing COVID-19 pandemic has brought numerous ethical dilemmas to the forefront of clinical care, including for resident and fellow physician trainees. In this paper, the authors draw on their own experiences providing frontline COVID-19 clinical care in New York City in their respective roles as an internal medicine resident and later a pulmonary and critical care fellow, and as an associate program director for a pulmonary and critical care fellowship, along with published literature on trainees' experiences in the pandemic, to describe common ethical dilemmas confronted by residents and fellows during the pandemic. These dilemmas are related to personal health risk, resource allocation, health care inequities, and media relations. The authors use a framework of microethics to underscore how these dilemmas are highly contextualized within trainees' institutions, their specific roles, and the patient populations to which they provide care. They argue that frequent ethical dilemmas, compounded by the intense physical and emotional stress of medical training and the pandemic itself, increase the potential for trainees to experience moral distress. Recurrent moral distress may, in turn, put trainees at risk for moral injury with consequences for their mental health and overall well-being. It is imperative to gain a clear understanding of this issue, not only for those trainees who have experienced or are at risk for experiencing personal consequences but also because it may help identify ways to better support the well-being of providers and the care of patients going forward.
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http://dx.doi.org/10.1097/ACM.0000000000004536 | DOI Listing |
Indian J Radiol Imaging
January 2025
Department of Neurology, Division of Cerebrovascular Medicine and Neurology, National Cerebral and Cardiovascular Center (NCVC), Suita, Osaka, Japan.
Physician-scientists serve as conduits between clinical practice and scientific research, leveraging their unique expertise to improve patient care and drive medical innovation. This article highlights the indispensable role of research and publishing in promoting evidence-based practices, facilitating professional growth, and shaping public health policy. Drawing on historical and contemporary examples, I examine the challenges faced by physician-scientists, such as ethical dilemmas and declining engagement in research, particularly in resource-constrained settings.
View Article and Find Full Text PDFJ Relig Health
January 2025
School of Social Sciences, 20 Chancellor's Walk, Monash University, Melbourne, VIC, 3880, Australia.
Healthcare (Basel)
December 2024
Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland.
Dissocial personality is understood as a personality that does not ideologize most social norms and is characterized by a lack of empathy. Precise criteria for diagnosing dissocial personality are included in the ICD-10 classification, which is still in force in Poland. This classification is widely available in both Polish and English.
View Article and Find Full Text PDFPhilos Ethics Humanit Med
January 2025
Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, The Alfred Hospital, Monash University, Melbourne, Australia.
Background: Moral distress is reported to be a critical force contributing to intensifying rates of anxiety, depression and burnout experienced by healthcare workers. In this paper, we examine the moral dilemmas and ensuing distress personally and collectively experienced by healthcare workers while caring for patients during the pandemic.
Methods: Data are drawn from free-text responses from a cross-sectional national online survey of Australian healthcare workers about the patient care challenges they faced.
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