Moral Distress and Ethical Sensitivity in Critical Care Professionals: A Scoping Review
DOI:
https://doi.org/10.1344/rbd2025.63.45061Keywords:
Ethical sensitivity, Health prefessions, Moral distress, Intensive Care Units, COVID-19Abstract
Objective: To describe and synthesize the scientific literature published between 2017 and 2023 on the psychological impact of moral distress and ethical sensitivity in healthcare professionals in Intensive Care Units. Methodology: A Scoping Review was designed by searching the following databases: Medline, Scopus, ScienceDirect, Dialnet, Scielo. Search equations used were: "Effects of moral distress AND health personnel" and "effects of ethical sensitivity AND healthcare personnel". Information was extracted on variables related to moral distress and ethical sensitivity, a database was designed to classify the information, synthesize it and perform a hermeneutic analysis. Results: internal and external factors related to moral distress and ethical sensitivity were identified; internal factors were frustration, impotence and anger; external factors were hospital policies, hierarchy in the ICU and lack of communication. When suffering moral distress and decreasing ethical sensitivity, lack of empathy and mental fatigue were identified. However, there is greater development of ethical sensitivity when group activities are carried out in the search for new knowledge and assertive communication strategies. Conclusion: health professionals working in ICUs are exposed to suffer moral distress and their ethical sensitivity is tested daily; as a result of the COVID-19 pandemic the ethical challenges experienced become more evident, this has increased symptoms of moral distress such as feelings of guilt, worry and loss of confidence. Ethical sensitivity is important in ICUs to recognize and understand the problems of healthcare workers.
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