2020
DOI: 10.3389/fped.2020.00581
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Moral Distress in the Neonatal Intensive Care Unit: What Is It, Why It Happens, and How We Can Address It

Abstract: Moral distress is prevalent in the neonatal intensive care unit (NICU), where decisions regarding end-of-life care, periviable resuscitation, and medical futility are common. Due to its origins in the nursing literature, moral distress has primarily been reported among bedside nurses in relation to the hierarchy of the medical team. However, it is increasingly recognized that moral distress may exist in different forms than initially described and that healthcare professions outside of nursing experience it. A… Show more

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Cited by 71 publications
(84 citation statements)
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“…Studies on moral distress of healthcare professionals in NICUs found that, although moral distress can arise in any complex decision-making, it is often associated with treatment decisions for EPIs [ 47 , 48 ]. Institutional structures, in particular unit culture and inadequate guidelines, were often reported as one of the causes of moral distress [ 46 48 ].…”
Section: Discussionmentioning
confidence: 99%
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“…Studies on moral distress of healthcare professionals in NICUs found that, although moral distress can arise in any complex decision-making, it is often associated with treatment decisions for EPIs [ 47 , 48 ]. Institutional structures, in particular unit culture and inadequate guidelines, were often reported as one of the causes of moral distress [ 46 48 ].…”
Section: Discussionmentioning
confidence: 99%
“…Studies on moral distress of healthcare professionals in NICUs found that, although moral distress can arise in any complex decision-making, it is often associated with treatment decisions for EPIs [ 47 , 48 ]. Institutional structures, in particular unit culture and inadequate guidelines, were often reported as one of the causes of moral distress [ 46 48 ]. Interestingly, studies found moral distress much more prevalent in cases in which practitioners felt they were “doing too much” compared to cases in which parents opted for palliative care [ 47 , 48 ].…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Both in paediatric and neonatal intensive care, professionals are commonly challenged by questions about their practice and the EDs they face. These can lead professionals to experience moral distress [22][23][24][25]. In the daily practice of paediatric and neonatal intensive care, moral distress is frequent and relates to several difficult situations dealing with the patients' outcome and management but also with difficulties in communication among team members.…”
Section: Discussionmentioning
confidence: 99%
“…In this sense, in not adequate to treat premature as things or products, and to dictate that a life with no good quality is not good. (Mills, 2020) The utilitarianism principle also supports what is best for all for the majority of people, as society, bene ts in the saving of economic resources, because the survival outcome is very di cult and costly. In this sense, they might argue that resources are better spend in the generation of pleasure and satisfaction instead pain and incapacity.…”
Section: Discussionmentioning
confidence: 99%