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.
child education
When School’s Out, Community Steps In
Community: The joy of being a kid on summer vacation offers a time to explore with your friends, discover new things about the world and yourself and recharge for a few months before heading back to school in the fall. However, for millions of families, the end of the school year also marks the beginning of a stressful season filled with tough choices, as children can fall behind in the months away from the classroom.
(Feature Impact) The joy of being a kid on summer vacation offers a time to explore with your friends, discover new things about the world and yourself and recharge for a few months before heading back to school in the fall. However, for millions of families, the end of the school year also marks the beginning of a stressful season filled with tough choices, as children can fall behind in the months away from the classroom.
The summer gap begins when the school doors close and many children lose access to the daily routines, educational support and dependable nutrition that help them thrive. For families already juggling tight budgets and demanding schedules, summer can quickly become a season of added pressure and stress.
Summer learning loss – or the decline in academic skills and learning during the school break – can have a lasting impact on academic outcomes. Studies show over the summer, students can forget 20-30% of what they learned during the school year. Without the right support, students often start the new school year playing catchup, which can cause them to fall further behind.
Summer can also intensify food insecurity. Of the more than 22 million kids who rely on free or reduced-priced school meals, many lose access to these vital programs over the summer. When those meals disappear, families must stretch already limited budgets to cover up to 10 additional meals a week per child. In fact, recent United Way Worldwide data from 211 – the free 24/7 helpline that connects people with local resources – identified food access as one of the most pressing needs facing millions of families nationwide.
These overlapping pressures fall especially hard on millions of working families living paycheck to paycheck, including ALICE (Asset Limited, Income Constrained, Employed) households. They earn above the federal poverty level but still struggle to afford basic expenses like housing, medicine, food and transportation.
Addressing the summer gap requires a community-wide approach and solutions that meet hardworking families where they are. For example, United Way Community Schools are community-based hubs that bring together schools, social services agencies, volunteers and other community partners to provide students and families with essential support like tutoring, food access and health and wellness resources.
Families also need easy, practical, daily tips and local resources to make ends meet and help their kids stay on track.
Learning that Fits Your Day
For busy families, low- or no-cost learning moments that fit into packed schedules can make a real difference. Many communities and nonprofits offer dedicated programs to keep children active and learning during the summer, such as:
- Summer art classes, creative writing workshops and digital literacy tutoring at local libraries
- Free monthly book deliveries and reading challenges through Dolly Parton’s Imagination Library – a United Way partner – or book exchanges at Little Free Libraries in high-traffic areas
- Gardening classes, nature appreciation classes and swim lessons through local parks and recreation departments
- Free weekly youth workshops offered by many public museums, zoos and botanical gardens
- Free virtual museum field trips through institutions like the Smithsonian and NASA Glenn Research Center
- Free online courses in topics ranging from coding to art or language learning
Accessing Your Community’s Food Network
Families shouldn’t have to choose between nutritious food and other essentials. Help is available to ensure kids have the nutrition needed to thrive over the summer. While resources vary by community, examples include:
- Youth-serving organizations serving as open summer meal sites, offering free breakfast and lunch to kids and teens
- City parks departments offering daily meal stations
- School districts offering summer meal programs; food delivery may be an option
- Local places of worship hosting open-door meal programs or distributing weekend grocery bags for families
For those looking to make a difference this summer, consider lending a hand to help children and families. Volunteering is a rewarding way to give back to your community. Whether it’s mentoring, serving meals, reading with students or supporting local programs, even a small time investment can make a lasting impact. After all, when families thrive, communities thrive.
To learn more about childhood summer learning programs, food initiatives and ways to support your community, visit unitedway.org.
SOURCE:
The Bridge is a section of the STM Daily News Blog meant for diversity, offering real news stories about bona fide community efforts to perpetuate a greater good. The purpose of The Bridge is to connect the divides that separate us, fostering understanding and empathy among different groups. By highlighting positive initiatives and inspirational actions, The Bridge aims to create a sense of unity and shared purpose. This section brings to light stories of individuals and organizations working tirelessly to promote inclusivity, equality, and mutual respect. Through these narratives, readers are encouraged to appreciate the richness of diverse perspectives and to participate actively in building stronger, more cohesive communities.
https://stmdailynews.com/the-bridge
Community
StarKist® and Feed the Children Team Up Again to Help Put Child Hunger to Bed™
StarKist and Feed the Children are expanding the Put Child Hunger to Bed campaign (May 1–Sept 30, 2026), donating up to 100,000 pouches and matching up to $100,000 in donations.
Child hunger isn’t an abstract issue—it’s a daily reality for families in communities across the U.S. That’s why StarKist® is renewing its long-running partnership with Feed the Children through the Put Child Hunger to Bed™ campaign, turning simple, everyday actions into tangible support for kids who need it most.
Announced April 30, 2026, the campaign runs May 1 through September 30, 2026, and gives consumers two straightforward ways to participate: buy a product many already keep in their pantry, or donate directly online. Either way, the goal is the same—help more children and families access nutritious food and essential resources.
Two ways everyday choices can make an impact
StarKist is inviting shoppers to join the movement with built-in giving tied to routine purchases:
- Buy a tuna pouch, give a pouch: For every StarKist tuna pouch purchased, StarKist will donate one pouch to Feed the Children, up to 100,000 pouches.
- Donate online, double the impact: StarKist will match consumer donations dollar-for-dollar, up to $100,000, when donations are made through the campaign site.
Consumers can learn more or donate directly at StarKist.com/feedthechildren.
A partnership with more than 15 years behind it
StarKist and Feed the Children aren’t new collaborators. According to StarKist, the organizations have worked together for more than 15 years, combining product donations and financial contributions to support children and families experiencing hunger and hardship.
Michael Merritt Jr., Vice President and Head of Marketing & Innovation at StarKist, said the campaign is designed to make participation easy and meaningful—so consumers can be part of the solution through actions that fit naturally into everyday life.
Feed the Children also emphasized the broader impact: when families have reliable access to food and essentials, it doesn’t just help them get through today—it supports children’s development and future opportunities.
Jax joins the campaign to amplify awareness
To help bring the message to more families and communities, StarKist is partnering with a group of creators and advocates, including musician and mom Jax (@jax), who has 14.7 million TikTok followers and is known for uplifting, relatable content.
Jax shared that becoming a mom has deepened her perspective on food insecurity—and that no child should have to wonder where their next meal is coming from. As part of the collaboration, she’s also teaming up with Charlie The Tuna® for a new jingle tied to the campaign.
More voices joining the movement
Alongside Jax, StarKist is working with additional creators to encourage participation and share practical ways to support families:
- Becca Kufrin (@bkoof) – TV personality and mom
- Kit Hoover (@kithoover) – TV host
- Marina Chaparro (@nutrichicos) – Registered pediatric dietitian
- Samantha Busch (@samanthabusch) – Lifestyle influencer and philanthropist
The mix of entertainment, family lifestyle, and nutrition voices is intentional: the campaign is built to meet people where they already are—online, in stores, and in daily routines.
Why tuna pouches are the campaign’s centerpiece
StarKist is centering the campaign around its tuna pouches because they’re designed for convenience and nutrition—ready-to-eat, fully cooked, and available in more than 20 varieties. The company notes that each pouch delivers 12 grams or more of protein, making it an easy option for quick lunches, snacks, or on-the-go meals.
The bigger idea: when a product is already part of a household routine, tying it to giving can help scale impact—turning a small choice into support for families facing food insecurity.
How to get involved
If you want to participate between May 1 and September 30, 2026, you can:
- Purchase any StarKist tuna pouch (any size, type, or flavor) at your local grocery store or retailer
- Visit StarKist.com/feedthechildren to learn more or donate (with matching available up to the campaign limit)
Together, StarKist and Feed the Children say they’re working toward a shared goal: helping ensure kids can focus on growing, learning, and dreaming—rather than worrying about their next meal.
About the organizations
- StarKist Co. is a socially responsible company focused on convenient, nutritious proteins, known for its single-serve pouch products and its longtime mascot, Charlie The Tuna®.
- Feed the Children is a global nonprofit working to end childhood hunger in the U.S. and around the world by providing food, essentials, and opportunities to children and families.
To read more about community-related events, visit www.stmdailynews.com and search for “community.”
The Bridge
McKinley Thompson: African American Auto Designer
The first-generation Bronco was designed by McKinley Thompson Jr., Ford’s first African American designer. This highlights his significant contribution to the automotive industry during Black History Month.
The first-generation Bronco was designed by McKinley Thompson Jr., who was the first African American designer hired at Ford Motor Company.
Edited by: Rod Washington
Images: Ford Motor Company
Storyblocks
Wikipedia Wiki Commons
Visit: https://stmdailynews.com/category/the-bridge/black-history/
