Palliative and hospice social workers' moral distress during the COVID-19 pandemic

Abigail Latimer, Sophia Fantus, Theresia M. Pachner, Kalea Benner, Victoria Leff

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Objectives Moral distress is associated with adverse outcomes contributing to health-care professionals' worsened mental and physical well-being. Medical social workers have been frontline care providers throughout the COVID-19 pandemic, and those specializing in palliative and hospice care have been particularly affected by the overwhelming numbers of those seriously ill and dying. The main objectives of this study were (1) to assess palliative and hospice social workers' experiences of moral distress during COVID-19 and (2) to identify and describe participants' most morally distressing scenarios. Methods Using a mixed-methods approach, participants completed an online survey consisting of the Moral Distress Thermometer (MDT) and open-ended text responses. Results A total of 120 social work participants responded to the study, and the majority of participants (81.4%) had experienced moral distress with an average MDT score of 6.16. COVID-19 restrictions emerged as the main source of moral distress, and an overlap between the clinical and system levels was observed. Primary sources of moral distress were grounded in strict visitation policies and system-level standards that impacted best practices and personal obligations in navigating both work responsibilities and safety. Significance In the first year of the COVID-19 pandemic, palliative and hospice social work participants indicated high levels of moral distress. Qualitative findings from this study promote awareness of the kinds of distressing situations palliative and hospice social workers may experience. This knowledge can have education, practice, and policy implications and supports the need for research to explore this aspect of professional social work.

Original languageEnglish
JournalPalliative and Supportive Care
Issue number4
StatePublished - Sep 27 2022

Bibliographical note

Publisher Copyright:
© The Author(s), 2022. Published by Cambridge University Press.


  • Burnout
  • COVID-19
  • Moral distress
  • Organizational support
  • Social work

ASJC Scopus subject areas

  • General Nursing
  • Clinical Psychology
  • Psychiatry and Mental health


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