Reflections on How We Teach Ethics: Moral Failure in Critical Care

Critical care is one of the most ethically complex health care specialties. Nurses working in this highly intense setting face additional stressors of high-tech interventions, resource scarcity, and increased workloads. Evidence from the United Kingdom and the United States suggests that these stressors are affecting patient safety and mortality, and nurses are feeling dissatisfied with their job and are burning out.^1–4  Although we are able to keep patients alive longer, a growing body of research suggests that in many cases the life-sustaining treatments carried out in critical care settings are perceived by health care professionals to conflict with the patient’s best interests, creating moral distress among health care professionals.^5,6  Nurses are often left out of decision-making processes, yet they are responsible for enacting the decisions made. This situation, according to Liaschenko,⁷  reduces nurses to artificial persons—persons who speak or act for others...