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Letters
April 4, 2012

Perceptions of Appropriateness of Care in the Intensive Care Unit

Author Affiliations

Author Affiliations: Department of Medical Ethics and Health Policy, University of Pennsylvania School of Nursing, Philadelphia (Dr Ulrich) (culrich@nursing.upenn.edu); and Department of Bioethics, National Institutes of Health Clinical Center, Bethesda, Maryland (Dr Grady).

JAMA. 2012;307(13):1370-1372. doi:10.1001/jama.2012.394

To the Editor: Moral distress is a common problem in today's health care environment. Dr Piers and colleagues1 shed light on this important ethical concept in their international study of ICU nurses and physicians. They showed that a perception of providing inappropriate care was associated with moral distress and intent to leave one's job. This study raises awareness of the impact of ethics in day-to-day clinical care and attention to the concerns of direct caregivers, but also raises a number of questions.

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