Wed Feb 05 08:08:20 UTC 2025: ## Medical Mistrust Fuels Ethical Dilemmas in Healthcare: Doctors Face Moral Distress

**Albany, NY – February 5, 2025** – A growing disconnect between patients, families, and medical professionals is creating significant ethical challenges in healthcare, particularly surrounding end-of-life care, according to Assistant Professor of Bioethics Daniel T. Kim of Albany Medical College. Writing in *The Conversation*, Kim highlights the rising moral distress experienced by clinicians forced to provide aggressive life support against their judgment, fueled by declining public trust in the medical system.

Kim uses the example of a six-month-old child with severe brain injury, where the mother’s insistence on life support, despite a bleak prognosis, created a difficult ethical dilemma for the medical team. While doctors are not obligated to provide futile treatments, determining what constitutes “futile” often involves subjective judgment calls. This is further complicated by a pervasive lack of trust, particularly amongst low-income and minority populations, exacerbated by the COVID-19 pandemic.

This mistrust creates a vicious cycle: families are less likely to accept medical advice to end aggressive treatment, leading to prolonged suffering for patients and intense moral distress for clinicians. Studies reveal alarmingly high levels of moral distress among healthcare workers, particularly in pediatric and neonatal intensive care, with many feeling a sense of guilt and “blood on their hands” even when acting ethically.

Kim argues that this distress is not a sign of wrongdoing, but rather a reflection of clinicians’ commitment to patient well-being. However, sustained moral distress can contribute to burnout and lead to healthcare professionals leaving their profession. The AMA reported 35.7% of physicians intending to leave practice within two years (2022-23).

To address this crisis, Kim suggests strengthening ethics consultation services, providing training on managing complex cases, and prioritizing strategies to improve communication and rebuild trust between patients, families, and medical professionals. He emphasizes the importance of shared decision-making based on mutual trust to ensure high-quality and ethical healthcare for all.

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