Moral distress arising from professionalism dilemmas among medical interns

Abstract

Background

Moral distress is defined as a psycho-emotional experience that occurs when individuals recognize the morally appropriate course of action but are unable to carry it out due to external constraints such as institutional hierarchies, organizational norms, or authority pressures. In medical education, this phenomenon is particularly frequent, given the deeply ethical nature of clinical decisions and patient care.Objective

The aim of this study was to translate and adapt the Moral Distress from Professionalism Dilemmas checklist into Brazilian Portuguese.Methods

The translation and cross-cultural adaptation process followed internationally recognized guidelines. It included independent translations by two professionals (one with and one without medical training), synthesis of the versions, back-translation, expert committee review, pretesting with 200 medical interns, and final evaluation.Results

Of the 200 medical students invited, 160 (80%) completed the checklist, with no significant differences by year or gender. Depending on the item, between 0 and 57.5% of participants reported exposure to the professionalism dilemmas investigated. Among exposed students, the intensity of moral distress varied considerably across situations.Conclusion

Moral distress is a prevalent phenomenon in medical education. The adapted checklist demonstrated semantic and conceptual equivalence to the original and may serve as a valuable tool to identify, quantify, and understand moral distress among medical students in clinical training.

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BibTeX RIS

BibTeX

@article{francci2026moral,
  title = {{Moral distress arising from professionalism dilemmas among medical interns}},
  author = {Giulia Francci and Laura Oliveira de Alcântara Ferraz and Marina da Rocha Brito and Rogério Aparecido Dedivitis},
  journal = {Revista da Associacao Medica Brasileira (1992)},
  year = {2026},
  month = oct,
  doi = {10.1590/1806-9282.20260580},
  url = {https://europepmc.org/article/PMC/PMC13693302},
  note = {CC BY},
}

RIS

TY  - JOUR
TI  - Moral distress arising from professionalism dilemmas among medical interns
AU  - Giulia Francci
AU  - Laura Oliveira de Alcântara Ferraz
AU  - Marina da Rocha Brito
AU  - Rogério Aparecido Dedivitis
PY  - 2026
DA  - 2026/10/23
JO  - Revista da Associacao Medica Brasileira (1992)
DO  - 10.1590/1806-9282.20260580
UR  - https://europepmc.org/article/PMC/PMC13693302
AB  - Background  Moral distress is defined as a psycho-emotional experience that occurs when individuals recognize the morally appropriate course of action but are unable to carry it out due to external constraints such as institutional hierarchies, organizational norms, or authority pressures. In medical education, this phenomenon is particularly frequent, given the deeply ethical nature of clinical decisions and patient care.Objective  The aim of this study was to translate and adapt the Moral Distress from Professionalism Dilemmas checklist into Brazilian Portuguese.Methods  The translation and cross-cultural adaptation process followed internationally recognized guidelines. It included independent translations by two professionals (one with and one without medical training), synthesis of the versions, back-translation, expert committee review, pretesting with 200 medical interns, and final evaluation.Results  Of the 200 medical students invited, 160 (80%) completed the checklist, with no significant differences by year or gender. Depending on the item, between 0 and 57.5% of participants reported exposure to the professionalism dilemmas investigated. Among exposed students, the intensity of moral distress varied considerably across situations.Conclusion  Moral distress is a prevalent phenomenon in medical education. The adapted checklist demonstrated semantic and conceptual equivalence to the original and may serve as a valuable tool to identify, quantify, and understand moral distress among medical students in clinical training.
SN  - 0104-4230
SN  - 1806-9282
ER  -

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