 | Cynda Rushton Anne and George Bunting Professor Clinical Ethics, Nursing, & Medicine - Johns Hopkins University |
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04.02.2015-27.02.2015
Re-conceptualizing moral distress in the context of advanced technology
The goal over the 6-8week residency at the Brocher Foundation is: 1) re-conceptualize a model for understanding moral distress among clinicians and leaders based on neuroscience, social psychology and contemplative practice and 2) develop an intervention that can be tested, replicated and disseminated in the US and globally. The specific goals of the project are: 1) To synthesize the current literature on moral distress in health care, with particular emphasis on emerging technologies and the impact on clinicians and health care leaders. 2) To understand the nature, sources, and impact of moral distress on health care leaders with emphasis on the use of advanced technologies. 3) Develop a model that re-conceptualizes moral distress in the context of effective agency and empowerment rather than victimization and shame as the basis for designing interventions to reduce the detrimental impact of moral distress on clinicians and leaders. 4) Refine an intervention to address moral distress based on social psychology, neuroscience and contemplative practice aimed at reducing moral distress for clinicians caring for people with serious illness who are receiving innovative technologies. 5) Develop a roadmap for team and organizational strategies for addressing moral distress of clinicians and leaders who are involved in providing technology driven care for people with serious illness. The focus is on developing interventions to support clinicians and leaders to reduce the impact of moral distress associated with the ethical issues associated with advanced medical technology for patients with serious illness. This area has been chosen for four reasons. First, it addresses a pervasive and serious issue that has not received sufficient attention or resources. Second, it builds on the state of the science documenting the detrimental effects of moral distress involving the use of a broad range of technologies and the looming issues of moral distress related to the implementation of the U.S. Affordable Care Act. Third, it builds on a program of scholarship that has focused on the sources and root causes of moral distress and a conceptual model for reducing the detrimental effects of moral distress on clinicians and leverages familiarity with the research in this area. Fourth, it expands the scope of inquiry of moral distress to include an exploration of moral distress as experienced by health care leaders who must make ethical decisions in these environments and who are responsible for organizational priorities, resource allocation, and fiscal stewardship. This is a vital aspect of aligning individual and organizational priorities and initiatives.
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