Ethicist Attempts To Garner Empathy For Physicians Suffering 'Moral Distress' But Misses The Mark (Video)

Article posted with permission from the author, Suzanne Hamner.

Recently, The Defender, the Children’s Health Defense internet publication, reposted an article found at The Conversation by Daniel T. Kim, Ph. D., MPH, titled “How Eroding Trust in Healthcare Affects Doctors and Their Patients”. It took several days to process this perspective from an individual who holds a chair on an “ethics review committee” to ensure that the reaction experienced from reading the article was not a “knee jerk” response.

Mr. Kim wrote:

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.

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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 from 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.

This worst-case scenario perspective was recognized as similar to the one used by many to justify the murder of babies in the womb – “if the life of the mother is at risk, …,” you know the rest. Then, this “doctor”, a Ph. D. (piled higher and deeper), has the gall to say landmark cases in the 70s through 90s established the rights of patients and families to refuse treatment.  Evidently, he is ignorant on the Ninth Amendment to the Constitution for the united States of America.  Clearly, the informed consent process has always included the right to choose treatment, refuse treatment, and stop treatment at any point. One can surmise Kim’s point is to foster sympathy for doctors amid failing public trust.

Kim continues to focus his point using this “worst-case scenario”. He states, “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.” According to Kim, “bioethicists” have emphasized trustworthiness as a core virtue of “good clinicians”.

He recognizes that trust in physicians as been declining in recent “decades”, with the US having lower trust in doctors than other industrialized countries, but fails to outline exactly why. Kim cites a survey from pharmaceutical company Sanofi indicating mistrust in the medical system is higher in “lower income and minority Americans, who experience discrimination and persistent barriers to care.” Could that mistrust be because of incidents like the Tuskegee experiment? Could that mistrust be because of the failure of the medical system to adequately treat those in lower income groups due to the cost? What about the lack of informed consent provided to patients in general? Then, there is the debacle of the CONvid-1984 planned scam-demic and the CONvid-1984 modified mRNA gene therapy bioweapon shots. What about the use of AI (artificial intelligence) protocols in the hospital used for treatment, not to mention the failure of physicians to engage in truthfulness themselves?

To his credit, he named the CONvid-1984 planned scam-demic debacle as playing a role in accelerating the public’s mistrust. However, he blamed a “thing” for the conscious choices of physicians.

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 healthcare 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.

Trust is something that has to be earned. The medical system had trust from the public, for the most part, until the CONvid-1984 planned scam-demic. There were plenty of victims of iatrocide (death by physician), medical kidnapping, bullying, denial of care for continued treatment due to a “pandemic”, and peddling of false information to the public by the medical system. Who could forget the various videos of choreographed “dancing nurses and hospital staff” that still circulate across the internet today? Yet, the public is to believe these healthcare workers suffer because of “mistrust”.

Is it any wonder no one wants to take any medical advice from a physician?

Kim then points out that 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.” Really? What about physicians/surgeons performing mutilating procedures on children to “change their sex” because the family requests it? This self-professed ethicist clearly avoided that topic.

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.

Sometimes those judgment calls are made without the proper information, such as with the CONvid-1984 modified mRNA gene therapy bioweapon shots. The public witnessed the doubling and tripling down of doctors to get those shots into every arm possible, including infants. They are more than happy to comply with edicts and recommendations without engaging in critical thinking that would play into “making a sound judgment call”.

Kim claims “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.” It seems engaging in shared decision-making went out the window years ago and was brought to prominence when the planned scam-demic burst on the scene.

If this wasn’t enough, Cynda Rushton, Oxford University, placed partial blame for the mistrust on the public.

Kim concludes with this.

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 healthcare.

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 healthcare 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 healthcare. Patients, their families and clinicians need to be able to trust each other to sustain high-quality care.

Sorry, but not sorry, Mr. Kim, your points ring hollow and point to an attempt to justify the downturn in physician ethics and morals as the result of public mistrust. One could argue it is the opposite – public mistrust is a result of a downturn in physician ethics and morals. Physicians refuse to recognize injuries and harms caused by childhood vaccines and the CONvid-1984 modified mRNA gene therapy bioweapon. Physicians and institutions protect their own when cases of medical negligence and gross incompetence arise. When one family, over the course of 40 years, has suffered the deaths of eight individuals due to medical negligence and gross incompetence, it is difficult to muster any type of confidence in the medical system. And, when the public witnessed numerous deaths of their family members due to medical mismanagement, DNR orders placed on charts against family protestations, refusal to provide care, refusal to provide treatment if a patient had not taken a CONvid-1984 modified mRNA gene therapy bioweapon or had a cotton swab shoved up their nose for a useless “test”, and the habitual lack of physicians providing proper informed consent according to the informed consent process, it is difficult for many to see any type of “moral distress” in any individual within the current medical system. Moreover, it is rare these days for any “shared decision-making” to occur between physician, family and patient. It’s a “my way or the highway” mantra with physicians. And, don’t get this writer started on the egregious Obamacare with its rationed care, death panels, and changes in care to individuals over a certain age that physicians willingly supported and followed. One could say “a dollar makes ‘em holler” is the mantra of physicians today – CONvid-1984 increased reimbursement, following Obamacare “guidelines” for payment, pharmaceutical company kickbacks, etc.

Forgive some of us if we have little empathy for what is being described as “moral distress”. Many were witness to some type of “moral superiority” on the part of the medical system when it came to medical intervention and the blatant disrespect toward patients and family members when “questioning” treatment, practice, and care. This just didn’t start with the CONvid-1984 planned scam-demic. It has been brewing steadily over the past decades. The planned scam-demic brought it prominently into view.

The medical system refuses to learn its lesson. It would rather blame “things” or patients for its problems with morals, ethics, principles and values. If physicians are leaving the profession due to “moral distress”, these physicians should evaluate how their own actions contributed to their issues. A piece of advice, Mr. Kim. Back up and look at the situation from the patient and family view as well in context over the last four decades. Interview patients and families regarding their experience with the system and how they were treated by physicians, nurses, and medical institutions. Until then, stop trying to garner empathy for a system that frankly deserves none at this point.

Article posted with permission from Sons of Liberty Media