Healthcare professionals are moral agents whose fiduciary relationship with the public is animated by responsibility and the promise to use knowledge and skills to aid those in their care. When their ability to keep this promise is constrained or compromised, moral distress can result. Moral distress in healthcare is defined and outlined. Constraints and factors that lead to moral distress are identified as are the means that individual professionals and organizations use to address it. A call is made for transformative change to overcome a culture of silence and to sustain a healthcare system that is morally habitable.
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