It’s Not the Death, It’s the Dying: Moral Distress in Palliative Care ~ Pallimed

Moral distress – the discomfort, angst, and frustration related to situations in which we think we know the “right thing” to do, but cannot due to the situation – is endemic to palliative care and hospice work.

Some examples are:

• Aggressive chemotherapy for a dying cancer patient with days to live. 

• Dumping the truth on a patient overwhelmed and alone. 

• Following the treatment wishes of a family that which are incongruent with the patient who can’t speak for themselves. 

• Prolonging dying because a family says they are waiting for a miracle.

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The “crescendo effect” of moral distress is real and dangerous. It can linger for months and years. We all have a difficult case burned into our minds. The result of moral distress, especially if we are exposed to it frequently, causes emotional exhaustion, unrealistic expectations, close-mindedness, and boundary blurring between the suffering of the patient and the family and our own.

It’s Not the Death, It’s the Dying: Moral Distress in Palliative Care ~ Pallimed