Ethical challenges are commonplace in critical care settings. Questions about the boundaries of ethically permissible treatment, assessment of decision-making capacity, determining who ought to decide on the ultimate treatment plan, or potentially medically inappropriate treatment are part of everyday practice. Contradictory views can result in lack of consensus or unsatisfactory decisions between patients and family members, within interprofessional teams, or among patients, patients’ families, and critical care teams. Often at stake are each person’s central ethical values, obligations, and commitments. When confronted with these challenges, many clinicians experience moral distress in response to threats or violations of their integrity.1–5  Moral distress ensues when clinicians recognize ethical conflicts and their responsibility to respond to them but are unable to translate their moral choices into ethically grounded action that preserves integrity. Although controversies persist regarding the definition and contours of moral...

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