It now appears that doctors — caught between obligations to patients and the demands of insurance companies, administrators and even, occasionally, patients’ families — are feeling increasingly “trapped” and unable to do what they believe is ethically right. Researchers from the University of Virginia recently studied I.C.U. physicians and nurses and found that while doctors on average are less frustrated than nurses, they can also suffer from intense moral distress.
This finding doesn’t surprise me. It is profoundly disheartening to haggle with disembodied voices over the phone over insurance approval for operations to remove cancers, to struggle to do everything that should be done for the rising numbers of patients a single doctor must see, and to follow the wishes of estranged relatives who swoop into the hospital during the last days of life and demand aggressive treatment.
What can we do?
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