Moral Distress in the Care of Anesthetized Patients: The Experience of Iranian Anesthesiologists

Although ethical practice is critical in anesthesiology, few practical measures have been presented to implement ethical clinical practice to this specialty.

This study was performed aimed to identify Iranian anesthesiologists' perceptions of moral distress in caring of anesthetized patients.

This qualitative study was performed using conventional content analysis approach based on semi-structured interviews of 15 anesthesiologists which worked in the hospitals affiliated to Tehran University of Medical Sciences in 2019. The sampling method was purposive and the data were analyzed based on Granheim and Landmann method.

Ethical distress perceived by anesthesiologists was classified into the following eight categories: (i) Ethical distress regarding informed consent and respect for patient autonomy, (ii) Ethical distress regarding the cancellation or postponement of patient's surgery, (iii) Ethical distress regarding the anesthesiologist's relationship with patients undergoing surgery, (iv) Ethical distress regarding surgical patients' companions, (v) Ethical distress regarding patients' privacy and confidentiality, (vi) Ethical distress regarding surgeon's colleagues and other OR colleagues, (vii) Ethical distress regarding end-of-life patients, and (ix) Ethical distress regarding fair distribution of resources and equipment.

Implications for Practice: 

The findings of the present study can provide a better understanding of situations that cause moral distress for anesthesiologists and can be used in policy making and preparing ethical codes and ethical guidelines for working in the operating room. Identifying ethical distresses of anesthesiologists in the hospital is the first step in conducting managerial interventions to improve the state of clinical ethics and organizational ethics in a care provider setting.