• Daniel Garros, Wendy Austin, and Peter Dodek.
• Department of Pediatrics, John Dossetor Health Ethics Centre, University of Alberta, Edmonton, Alberta, Canada. Electronic address: dgarros@ualberta.ca.
• Chest. 2021 Apr 1; 159 (4): 148414921484-1492.

AbstractWorldwide, health-care professionals are experiencing unprecedented stress related to the coronavirus disease 2019 pandemic. Responding to a new virus for which there is no effective treatment yet and no vaccine is beyond challenging. Moral distress, which is experienced when clinicians are unable to act in the way that they believe they should, is often experienced when they are dealing with end-of-life care issues and insufficient resources. Both factors have been widespread during this pandemic, particularly when patients are dying alone and there is a lack of personal protection equipment that plagues many overburdened health-care systems. We explore here, guided by evidence, the concept and features of moral distress and individual resilience. Mitigation strategies involve individual and institutional responsibilities; the importance of solidarity, peer support, psychological first aid, and gratitude are highlighted.Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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