The Bridge
What the ‘moral distress’ of doctors tells us about eroding trust in health care
The article discusses the ethical dilemmas faced by healthcare providers when families demand life-sustaining treatments for patients unlikely to benefit, highlighting moral distress and trust issues.
Daniel T. Kim, Albany Medical College
I sit on an ethics review committee at the Albany Med Health System in New York state, where doctors and nurses frequently bring us fraught questions.
Consider a typical case: A 6-month-old child has suffered a severe brain injury following cardiac arrest. A tracheostomy, ventilator and feeding tube are the only treatments keeping him alive. These intensive treatments might prolong the child’s life, but he is unlikely to survive. However, the mother – citing her faith in a miracle – wants to keep the child on life support. The clinical team is distressed – they feel they’re only prolonging the child’s dying process.
Often the question the medical team struggles with is this: Are we obligated to continue life-supporting treatments?
Bioethics, a modern academic field that helps resolve such fraught dilemmas, evolved in its early decades through debates over several landmark cases in the 1970s to the 1990s. The early cases helped establish the right of patients and their families to refuse treatments.
But some of the most ethically challenging cases, in both pediatric and adult medicine, now present the opposite dilemma: Doctors want to stop aggressive treatments, but families insist on continuing them. This situation can often lead to moral distress for doctors – especially at a time when trust in providers is falling.
Consequences of lack of trust
For the family, withdrawing or withholding life-sustaining treatments from a dying loved one, even if doctors advise that the treatment is unlikely to succeed or benefit the patient, can be overwhelming and painful. Studies show that their stress can be at the same level as people who have just survived house fires or similar catastrophes.
While making such high-stakes decisions, families need to be able to trust their doctor’s information; they need to be able to believe that their recommendations come from genuine empathy to serve only the patient’s interests. This is why prominent bioethicists have long emphasized trustworthiness as a central virtue of good clinicians.
However, the public’s trust in medical leaders has been on a precipitous decline in recent decades. Historical polling data and surveys show that trust in physicians is lower in the U.S. than in most industrialized countries. A recent survey from Sanofi, a pharmaceutical company, found that mistrust of the medical system is even worse among low-income and minority Americans, who experience discrimination and persistent barriers to care. The COVID-19 pandemic further accelerated the public’s lack of trust.
In the clinic, mistrust can create an untenable situation. Families can feel isolated, lacking support or expertise they can trust. For clinicians, the situation can lead to burnout, affecting quality and access to care as well as health care costs. According to the National Academy of Medicine, “The opportunity to attend to and ease suffering is the reason why many clinicians enter the healing professions.” When doctors see their patients suffer for avoidable reasons, such as mistrust, they often suffer as well.
At a time of low trust, families can be especially reluctant to take advice to end aggressive treatment, which makes the situation worse for everyone.
Ethics of the dilemma
Physicians are not ethically obligated to provide treatments that are of no benefit to the patient, or may even be harmful, even if the family requests them. But it can often be very difficult to say definitively what treatments are beneficial or harmful, as each of those can be characterized differently based on the goals of treatment. In other words, many critical decisions depend on judgment calls.
Consider again the typical case of the 6-month-old child mentioned above who had suffered severe brain injury and was not expected to survive. The clinicians told the ethics review committee that even if the child were to miraculously survive, he would never be able to communicate or reach any “normal” milestones. The child’s mother, however, insisted on keeping him alive. So, the committee had to recommend continuing life support to respect the parent’s right to decide.
Physicians inform, recommend and engage in shared decision-making with families to help clarify their values and preferences. But if there’s mistrust, the process can quickly break down, resulting in misunderstandings and conflicts about the patient’s best interests and making a difficult situation more distressing. https://www.youtube.com/embed/MY4e4l-eAFk?wmode=transparent&start=0 Moral distress in health care.
Moral distress
When clinicians feel unable to provide what they believe to be the best care for patients, it can result in what bioethicists call “moral distress.” The term was coined in 1984 in nursing ethics to describe the experience of nurses who were forced to provide treatments that they felt were inappropriate. It is now widely invoked in health care.
Numerous studies have shown that levels of moral distress among clinicians are high, with 58% of pediatric and neonatal intensive care clinicians in a study experiencing significant moral distress. While these studies have identified various sources of moral distress, having to provide aggressive life support despite feeling that it’s not in the patient’s interest is consistently among the most frequent and intense.
Watching a patient suffer feels like a dereliction of duty to many health care workers. But as long as they are appropriately respecting the patient’s right to decide – or a parent’s, in the case of a minor – they are not violating their professional duty, as my colleagues and I argued in a recent paper. Doctors sometimes express their distress as a feeling of guilt, of “having blood on their hands,” but, we argue, they are not guilty of any wrongdoing. In most cases, the distress shows that they’re not indifferent to what the decision may mean for the patient.
Clinicians, however, need more support. Persistent moral distresses that go unaddressed can lead to burnout, which may cause clinicians to leave their practice. In a large American Medical Association survey, 35.7% of physicians in 2022-23 expressed an intent to leave their practice within two years.
But with the right support, we also argued, feelings of moral distress can be an opportunity to reflect on what they can control in the circumstance. It can also be a time to find ways to improve the care doctors provide, including communication and building trust. Institutions can help by strengthening ethics consultation services and providing training and support for managing complex cases.
Difficult and distressing decisions, such as the case of the 6-month-old child, are ubiquitous in health care. Patients, their families and clinicians need to be able to trust each other to sustain high-quality care.
Daniel T. Kim, Assistant Professor of Bioethics, Albany Medical College
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Community
4 Ways to Preserve Veterans’ Stories for Future Generations
Family stories, photographs, letters and memories all have a place in the broader story of humanity, but if they aren’t recorded and preserved, they can fade over time. Consider these ways to help the veterans in your life preserve their stories and leave their mark on history. Preserve Veterans’ Stories for Future Generations
4 Ways to Preserve Veterans’ Stories for Future Generations
(Feature Impact) History is built from stories and memories, which is why it’s important to listen to the people who were there as the world changed. Family stories, photographs, letters and memories all have a place in the broader story of humanity, but if they aren’t recorded and preserved, they can fade over time.
Because more than 70 years have passed since the Korean War ended, opportunities to hear firsthand accounts from earlier conflicts grow fewer as time passes. Veterans and their families may be able to help record stories and lessons from “The Forgotten War” that might otherwise be lost.
You don’t need to be a historian to help preserve your loved ones’ memories and experiences. Programs like the Library of Congress Veterans History Project are dedicated to collecting stories from people like Private First Class Robert Lawrence Barber, who wrote regular letters home to his mother while serving in Korea. They paint a harrowing picture of combat, exhaustion, cold, fatigue and the stark realities of war that should never be forgotten. Experiences away from combat can be equally revealing, from daily routines and friendships to unexpected challenges.
Consider these ways to help the veterans in your life preserve their stories and leave their mark on history.
Start the Conversation Now
When it comes to recording memories, time is of the essence, especially for those who served in Korea. Decades may have passed, but each day makes a difference. Sit down with your loved one and gently start the conversation. You don’t have to get the entire backstory at once, but you can begin asking questions about their military experience and give them time to gather their thoughts.
Record Their Story
How a story is told can add dimension to the story itself. An audio or video recording preserves your loved one’s voice, expressions and emotions along with their words, giving your family memories to look back on for generations. Choose a quiet, comfortable space and test the equipment before recording.
Consider Preserving the Story Beyond Your Family
Family stories are most meaningful to those who know and love the storyteller, but they also matter to the world. Sharing veterans’ stories – including difficulties and ordinary moments – offers others a firsthand view of military life. Libraries and oral history archives may be able to preserve qualifying material for a wider audience.
“We want all stories, not just those from the foxhole or the battlefronts, but from all veterans who served the United States in uniform,” said Monica Mohindra, director of the Veterans History Project. “What did they hear? What did they see? What did it mean to them?”
If you have oral history interviews, and/or original photographs, letters or other records, consider contributing them to be archived and made accessible to future generations. Staff members are available to help you curate and select physical materials to contribute to the nation’s library.
Give Old Photos and Letters Context
Brush the dust off those old photo albums, scrapbooks and memory boxes because they may contain tangible pieces of history. A photograph, letter or piece of memorabilia could be what a veteran needs to bring fuzzy memories back into focus – whether it’s seeing the face of an old comrade or reading a letter written home. That gives you the opportunity to hear new stories and fill in context.
Learn more, discover veterans’ histories and find instructions for contributing veterans’ stories at loc.gov/vets.
Photo courtesy of Shutterstock (man looking at photo album)
Photo courtesy of the Library of Congress (group of soldiers)
SOURCE:
Library of Congress Veterans History Project
Community
5 Meaningful Ways to Make a Difference This Holiday Season
Make a Difference This Holiday Season: Hunger relief is often top of mind during the holidays, and there are many ways to make a meaningful difference. Consider these ideas.
5 Meaningful Ways to Make a Difference This Holiday Season
(Feature Impact) The holiday season brings people together and often inspires them to think about how they can support others. Yet for many families, this time of year can bring added pressure as they balance the cost of food and other everyday essentials.
According to Feeding America’s latest Map the Meal Gap study, published in 2026, nearly 48 million people in the United States, including 14 million children, experience food insecurity.
Hunger relief is often top of mind during the holidays, and there are many ways to make a meaningful difference. Each year, Charles Schwab employees come together through Season of Giving to support local nonprofits and help make the holidays brighter for those in need.
Consider these ideas from Charles Schwab Foundation, a nonprofit dedicated to advancing financial literacy and strengthening communities.
Give What’s Needed Most
When giving to a local food bank, pantry or other nonprofit, start by finding out what the organization needs most. Many organizations share lists of priority items, while monetary donations can give them flexibility to direct resources where they will have the greatest impact. A little planning can help make every contribution count.
Turn Giving Into a Group Activity
Invite family, friends, neighbors or coworkers to get involved with you. Organizing a donation drive, packing meals or volunteering together can multiply the impact while creating a meaningful way to connect during the holiday season.
Share Your Time and Talents
There are many ways to contribute beyond making a donation. Consider volunteering your time or putting your skills to use for an organization that could benefit from them. From sorting donations and packing meals to helping with special events or administrative projects, your time and expertise can make a meaningful impact.
Support Organizations in Your Own Community
The holidays are an opportunity to learn more about the organizations serving your neighbors every day. Look for local nonprofits addressing needs that matter to you, whether that is hunger, housing, education or another community priority. Supporting organizations close to home can help strengthen the networks people rely on throughout the year.
Keep Giving Beyond the Holidays
The spirit of giving doesn’t have to end when the holiday season is over. Consider turning a one-time contribution into an ongoing commitment, whether by volunteering periodically, making recurring donations or continuing to support an organization with a mission that resonates with you.
Learn more about the work being done to advance financial literacy and strengthen communities at schwabmoneywise.com/foundation.
Photo courtesy of Shutterstock
SOURCE:
Last Updated on November 11, 2026 by Daily News Staff
Fifty volunteers joined Diana Gregory Outreach Services and community partners on November 5, with support from AARP, State Farm, and BHHS Legacy Foundation.
PHOENIX — Fresh produce and community support came together Thursday morning, November 5, 2026, as Veggies for Veterans distributed 700 grocery bags during an event hosted by the Phoenix VA Health Care System.
The Diana Gregory Outreach Services (DGOS) program brought together 50 volunteers to help provide veterans with nutritious food. Each bag contained a variety of 13 fruits and vegetables, according to the event results supplied by organizers.
The effort also received a contribution from Peddler’s Son, which donated a five-pound bag of Idaho potatoes and a bag of grapes for each veteran.
AARP, State Farm, and BHHS Legacy Foundation Lead Financial Support
AARP, State Farm, and BHHS Legacy Foundation were the event’s three largest financial sponsors, helping make the distribution possible.
Volunteers represented all three organizations, along with the Archer Ragsdale Arizona Chapter Tuskegee Airmen, Inc. Arizona Community Foundation and Santander also contributed volunteer support.
AARP Arizona State Director Dana Marie Kennedy attended the event. AARP’s participation included volunteers and an outreach table featuring candy and AARP-branded giveaway items for attendees and veterans.
Together, the financial contributions, donated food, and volunteer service supported an event centered on veterans and their access to fresh produce.
A Special Guest With a Remarkable Service History
Among those attending was 106-year-old Major Fannie Griffin McClendon, whose military career connects the gathering to an extraordinary chapter in American history.
McClendon served during World War II with the 6888th Central Postal Directory Battalion, widely known as the “Six Triple Eight.” The historic unit of Black women soldiers helped process a massive backlog of military mail in Europe.
Her service continued beyond World War II. The Library of Congress documents her later career in the Air Force, including service as a squadron commander.
Her attendance offered an opportunity to recognize a veteran whose career helped break barriers for Black women in the military.
More Than a Bag of Groceries
Veggies for Veterans’ purpose extends beyond the food distributed at an individual event. The program focuses on helping veterans access fresh produce while creating opportunities for connection and community support.
Grocery costs, transportation, and mobility can make obtaining nutritious food difficult. Bringing produce directly to veterans through VA and community settings is one way the program works to address those barriers.
The November 5 distribution also reflected the collective work behind that support: an organization coordinating the effort, a VA host, financial sponsors, a food donor, and volunteers contributing their time.
With 700 bags distributed and 50 volunteers participating, the event demonstrated how community partnerships can translate into practical support for veterans.
Readers interested in learning more about the program, volunteering, or exploring ways to support its work can visit Diana Gregory Outreach Services.
Reporting note: Event results, sponsor recognition, donations, volunteer participation, and attendee information were supplied for this recap. Historical background on Major McClendon is supported by the Library of Congress.
Sources and Further Information
- Diana Gregory Outreach Services — Veggies for Veterans
- Phoenix VA — November 5 Veggies for Veterans event listing
- Library of Congress — Fannie Griffin McClendon
