Case studyThe cost of caring

Consistent exposure to moral distress impairs a physician’s quality of life, personal and professional identity, heightens the risk of burnout and maladaptive coping strategies, impairs clinical decision-making, and hampers interprofessional interactions that compromise overall patient care. Perhaps one of the most common sources of moral distress is caring for dying patients. Our reviews on moral distress, and the impact of death and dying, reveal that when unsupported, these experiences undermine a physician’s ability to provide personalised, holistic, and patient-centred care.

Our reviews also suggest that a better understanding of how physicians cope is possible by charting changes in their self-concept of personhood or “what makes you, you”. To this end, we apply the Ring Theory of Personhood (RToP) to interviews with clinicians in order to map coping and maladaptation. To sketch the spectrum of coping responses, we invite palliative care, oncologists, renal physicians, and emergency physicians who care for those facing end of life, from sudden death to death following chronic illness. We believe that this will aid us in informing efforts to shape educational and support mechanisms to help physicians in these fields and beyond.