title: Moral distress in rehabilitation professionals: results from a hospital ethics survey.
abstract: 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.
  
  
  METHODS
  Online survey of employees.
  
  
  METHODS
  Urban rehabilitation system of care.
  
  
  METHODS
  The survey was open to all employees; 207 completed the survey.
  
  
  METHODS
  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.
authors.affiliation: Donnelley Family Disability Ethics Program, Rehabilitation Institute of Chicago, 345 E. Superior Street, South Mezzanine, Chicago, IL 60611, USA. dmukherjee@ric.org
authors.forename: Debjani
authors.initials: D
authors.lastname: Mukherjee
authors.forename: Rebecca
authors.initials: R
authors.lastname: Brashler
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Savage
authors.forename: Kristi L
authors.initials: KL
authors.lastname: Kirschner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003657:Decision Making / Q000941:ethics; D026690:Ethics, Clinical; D004991:Ethics, Institutional; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D008875:Middle Aged; D009014:Morals; D012046:Rehabilitation / Q000941:ethics*; D012047:Rehabilitation Centers / Q000941:ethics*; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D055815:Young Adult