The Experience of Moral Distress from the Perspective of Emergency Medicine Physicians and Nurses in the Emergency Department: A Qualitative Study

Masoudiyekta, Leila; Hassanpour Pazevar , Ehsan; Parsapour, Alireza; Shamsi Gooshki, Ehsan; Jalili, Mohammd; Shojaei, Amirahmad

doi:10.18502/ijme.v18i3.18843

Volume 18, Issue 1 (3-2025) IJMEHM 2025, 18(1): 1-17 | Back to browse issues page

‎ 10.18502/ijme.v18i3.18843

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Masoudiyekta L, Hassanpour Pazevar E, Parsapour A, Shamsi Gooshki E, Jalili M, Shojaei A. The Experience of Moral Distress from the Perspective of Emergency Medicine Physicians and Nurses in the Emergency Department: A Qualitative Study. IJMEHM 2025; 18 (1) : 3
URL: http://ijme.tums.ac.ir/article-1-6797-en.html

The Experience of Moral Distress from the Perspective of Emergency Medicine Physicians and Nurses in the Emergency Department: A Qualitative Study

Leila Masoudiyekta¹

, Ehsan Hassanpour Pazevar²

, Alireza Parsapour³

, Ehsan Shamsi Gooshki⁴

, Mohammd Jalili⁵

, Amirahmad Shojaei ^*

⁶

1- PhD Student, Department of Medical Ethics, Research Center for Medical Ethics and History of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Nursing, Faculty of Nursing and Midwifery, Dezful University of Medical Sciences, Dezful, Iran
2- General Medicine Student, Tehran University of Medical Sciences, Tehran, Iran
3- Assistant Professor, Research Center for Medical Ethics and History, Tehran University of Medical Sciences, Tehran. Iran.
4- Associate Professor, Medical Ethics and History or Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran; Lecturer in Bioethics, Monash Bioethics Center, Monash University, Melbourne, Australia
5- Professor, Department of Emergency Medicine, School of Medicine،Editor-in-Chief, Frontiers in Emergency Medicine (FEM)،Co-founder and Director, Health Professions' Education Research Center (HPERC)،Tehran University of Medical Sciences, Tehran, Iran
6- Associate Professor, Medical Ethics and History or Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran

Abstract: (297 Views)

Moral distress constitutes a significant challenge for healthcare professionals, arising when individuals find themselves unable to act in accordance with their personal and professional values due to both internal and external pressures. Healthcare professionals may face scenarios that prompt them to question the ethical acceptability of their decisions and treatment practices, often feeling powerless in the face of perceived unethical changes. This study sought to explore the experiences of moral distress encountered by emergency medicine physicians and nurses in the emergency department. This study was conducted using qualitative content analysis. Data were collected through semi-structured interviews with 25 healthcare providers selected via purposive sampling. Data analysis was conducted using MAXQDA 2018 software. The results indicated that the experiences of moral distress among emergency medicine physicians and nurses in the emergency department can be classified into four primary categories including those related to: 1. patient rights, 2. medical staff and colleagues, 3. management, and 4. professionals. Notably, factors such as overcrowding, inadequate staffing, discrepancies between salaries and workloads, and poor management of human and physical resources emerge as significant contributors to moral distress in the emergency department of Imam Khomeini Hospital. To improve patient care quality, it is essential to implement strategies that enhance triage processes, prioritize human resources, align resources with patient needs, monitor patient attendance, and develop a comprehensive protocol for staff.

Article number: 3

Keywords: Emergency, Medicine, Physicians, Nurses, Moral distress

Full-Text [PDF 635 kb] (118 Downloads)

Type of Study: Research | Subject: Medical Ethics
Received: 2024/09/29 | Accepted: 2025/03/2 | Published: 2025/03/21