Moral injury and the four pillars of bioethics [version 4; peer review: 2 approved]
Healthcare providers experience moral injury when their internal ethics are violated. The routine and direct exposure to ethical violations makes clinicians vulnerable to harm. The fundamental ethics in health care typically fall into the four broad categories of patient autonomy, beneficence, nonma...
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| Format: | Article |
| Language: | English |
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F1000 Research Ltd
2023-12-01
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| Series: | F1000Research |
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| Online Access: | https://f1000research.com/articles/8-1193/v4 |
| _version_ | 1827348702085251072 |
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| author | Thomas F Heston Joshuel A Pahang |
| author_facet | Thomas F Heston Joshuel A Pahang |
| author_sort | Thomas F Heston |
| collection | DOAJ |
| description | Healthcare providers experience moral injury when their internal ethics are violated. The routine and direct exposure to ethical violations makes clinicians vulnerable to harm. The fundamental ethics in health care typically fall into the four broad categories of patient autonomy, beneficence, nonmaleficence, and social justice. Patients have a moral right to determine their own goals of medical care, that is, they have autonomy. When this principle is violated, moral injury occurs. Beneficence is the desire to help people, so when the delivery of proper medical care is obstructed for any reason, moral injury is the result. Nonmaleficence, meaning do no harm, has been a primary principle of medical ethics throughout recorded history. Yet today, even the most advanced and safest medical treatments are associated with unavoidable, harmful side effects. When an inevitable side effect occurs, the patient is harmed, and the clinician is also at risk of moral injury. Social injustice results when patients experience suboptimal treatment due to their race, gender, religion, or other demographic variables. While minor ethical dilemmas and violations routinely occur in medical care and cannot be eliminated, clinicians can decrease the prevalence of a significant moral injury by advocating for the ethical treatment of patients, not only at the bedside but also by addressing the ethics of political influence, governmental mandates, and administrative burdens on the delivery of optimal medical care. Although clinicians can strengthen their resistance to moral injury by deepening their own spiritual foundation, that is not enough. Improvements in the ethics of the entire healthcare system are necessary to improve medical care and decrease moral injury. |
| first_indexed | 2024-03-08T00:16:55Z |
| format | Article |
| id | doaj.art-42e9025628c942cd94782f9a0e77e1c7 |
| institution | Directory Open Access Journal |
| issn | 2046-1402 |
| language | English |
| last_indexed | 2024-03-08T00:16:55Z |
| publishDate | 2023-12-01 |
| publisher | F1000 Research Ltd |
| record_format | Article |
| series | F1000Research |
| spelling | doaj.art-42e9025628c942cd94782f9a0e77e1c72024-02-17T01:00:00ZengF1000 Research LtdF1000Research2046-14022023-12-018160270Moral injury and the four pillars of bioethics [version 4; peer review: 2 approved]Thomas F Heston0Joshuel A Pahang1Medical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, 99210-1495, USAMedical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, 99210-1495, USAHealthcare providers experience moral injury when their internal ethics are violated. The routine and direct exposure to ethical violations makes clinicians vulnerable to harm. The fundamental ethics in health care typically fall into the four broad categories of patient autonomy, beneficence, nonmaleficence, and social justice. Patients have a moral right to determine their own goals of medical care, that is, they have autonomy. When this principle is violated, moral injury occurs. Beneficence is the desire to help people, so when the delivery of proper medical care is obstructed for any reason, moral injury is the result. Nonmaleficence, meaning do no harm, has been a primary principle of medical ethics throughout recorded history. Yet today, even the most advanced and safest medical treatments are associated with unavoidable, harmful side effects. When an inevitable side effect occurs, the patient is harmed, and the clinician is also at risk of moral injury. Social injustice results when patients experience suboptimal treatment due to their race, gender, religion, or other demographic variables. While minor ethical dilemmas and violations routinely occur in medical care and cannot be eliminated, clinicians can decrease the prevalence of a significant moral injury by advocating for the ethical treatment of patients, not only at the bedside but also by addressing the ethics of political influence, governmental mandates, and administrative burdens on the delivery of optimal medical care. Although clinicians can strengthen their resistance to moral injury by deepening their own spiritual foundation, that is not enough. Improvements in the ethics of the entire healthcare system are necessary to improve medical care and decrease moral injury.https://f1000research.com/articles/8-1193/v4moral injury burnout bioethicseng |
| spellingShingle | Thomas F Heston Joshuel A Pahang Moral injury and the four pillars of bioethics [version 4; peer review: 2 approved] F1000Research moral injury burnout bioethics eng |
| title | Moral injury and the four pillars of bioethics [version 4; peer review: 2 approved] |
| title_full | Moral injury and the four pillars of bioethics [version 4; peer review: 2 approved] |
| title_fullStr | Moral injury and the four pillars of bioethics [version 4; peer review: 2 approved] |
| title_full_unstemmed | Moral injury and the four pillars of bioethics [version 4; peer review: 2 approved] |
| title_short | Moral injury and the four pillars of bioethics [version 4; peer review: 2 approved] |
| title_sort | moral injury and the four pillars of bioethics version 4 peer review 2 approved |
| topic | moral injury burnout bioethics eng |
| url | https://f1000research.com/articles/8-1193/v4 |
| work_keys_str_mv | AT thomasfheston moralinjuryandthefourpillarsofbioethicsversion4peerreview2approved AT joshuelapahang moralinjuryandthefourpillarsofbioethicsversion4peerreview2approved |