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dc.contributor.authorDzeng, Elizabethen
dc.contributor.authorColaianni, Alessandraen
dc.contributor.authorRoland, Martinen
dc.contributor.authorLevine, Daviden
dc.contributor.authorKelly, Mikeen
dc.contributor.authorBarclay, Stephenen
dc.contributor.authorSmith, Thomas Jen
dc.date.accessioned2015-09-03T09:20:23Z
dc.date.available2015-09-03T09:20:23Z
dc.date.issued2015-09-21en
dc.identifier.citationDzeng et al. Journal of General Internal Medicine (2015) Vol. 31, Issue 1, pp. 93-99. doi: 10.1007/s11606-015-3505-1en
dc.identifier.issn0884-8734
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/250447
dc.description.abstractBackground: Ethical challenges are common in end of life care; the uncertainty of prognosis and the ethically permissible boundaries of treatment create confusion and conflict about balance of benefits and burdens experienced by patients. Objective: We asked physician trainees in internal medicine how they reacted and responded to ethical challenges arising in the context of perceived futile treatments at the end of life, and how these challenges contribute to moral distress. Design: Semi-structured in-depth qualitative interviews Participants: 22 internal medicine residents and fellows across three American academic medical centers. Approach: This qualitative study was exploratory in nature, intended to deepen conceptual understanding of underlying phenomena that drive physician attitudes and behavior. Key Results: Physician trainees experience significant moral distress when they feel obligated to provide treatments at or near the end of life that they believe to be futile. Some trainees developed detached and dehumanizing attitudes towards patients as a coping mechanism, which may contribute to a loss of empathy. Successful coping strategies included formal and informal conversations with colleagues and superiors about the emotional and ethical challenges of providing care at the end of life. Conclusions: Moral distress amongst physician trainees may occur when they feel obligated to provide treatments at the end of life that they believe to be futile or harmful.
dc.description.sponsorshipThis study was funded by the Health Resources and Service Administration T32 HP10025-20 Training Grant, the Gates Cambridge Scholarship, Society of General Internal Medicine Founders Grant, and the Ho-Chiang Palliative Care Research Fellowship at the Johns Hopkins School of Medicine.
dc.languageEnglishen
dc.language.isoenen
dc.publisherSpringer
dc.titleMoral Distress Amongst American Physician Trainees Regarding Futile Treatments at the End of Life: A Qualitative Inquiryen
dc.typeArticle
dc.provenanceOA-5020
dc.description.versionThis is the author accepted manuscript. The final version is available from Springer via http://dx.doi.org/10.1007/s11606-015-3505-1en
prism.endingPage99
prism.publicationDate2015en
prism.publicationNameJournal of General Internal Medicineen
prism.startingPage93
prism.volume31en
dc.rioxxterms.funderHealth Resources and Service Administration
dc.rioxxterms.funderGates Cambridge Scholarship
dc.rioxxterms.funderSociety of General Internal Medicine
dc.rioxxterms.funderHo-Chiang Palliative Care Research Fellowship
dc.rioxxterms.projectidT32 HP10025-20
dcterms.dateAccepted2015-08-14en
rioxxterms.versionofrecord10.1007/s11606-015-3505-1en
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2015-09-21en
dc.contributor.orcidRoland, Martin [0000-0002-8533-3060]
dc.contributor.orcidKelly, Mike [0000-0002-2029-5841]
dc.contributor.orcidBarclay, Stephen [0000-0002-4505-7743]
dc.identifier.eissn1525-1497
rioxxterms.typeJournal Article/Reviewen
rioxxterms.freetoread.startdate2016-09-21


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