Professional Ethical Values Research Articles

ETIKA KONSELING DALAM ERA DIGITAL: ANCAMAN DAN PELUANG INTERNASIONAL

Counseling becomes a necessity, because the essence of counseling is the help of an expert counselor given to someone to solve their problems. In providing these services, a counselor is governed by ethics, attitudes and personal qualities for the counselor to behave. Professional ethical values are very important in the helping profession. The code of ethics for counselors is established by the counselor professional institution. For the Indonesian territory, the code of ethics for counselors is determined by the Indonesian Counseling Guidance Association, which is abbreviated as ABKIN. A code of ethics is a guide or guideline for professional behavior or a moral foundation that is practiced, secured and upheld by counselors as members of professional organizations. The aim of this research is to describe the professional ethics of counselors in counseling guidance services in the digital era. The method used in this research is a literature study with a qualitative descriptive approach. The data source comes from collecting documents in the form of books and previous research originating from various references. The data analysis technique used is descriptive analysis. The results of this research show that online counseling ethics takes the form of virtual counseling technology, websites, email, video conferences, instant messaging, computers and other social networks. Therefore, online counselors need to be professional in conducting virtual counseling by paying attention to ethics.

Are Turkish doctors in deep water? The role of professional ethics and factors affecting the medical brain drain: A qualitative study from Turkey.

With the increased rate of the Turkish medical brain drain (MDB) in recent years, there is a need for more comprehensive studies to elucidate its vague migratory factors. The aim of this paper is to try to narrow that gap by analyzing present impacts of the MDB in Turkey and to evaluate if these aspects were driven by professional ethical values, and if so, what ethical principles they were based on. In-depth interviews were conducted with 19 doctors from various backgrounds, followed by a thematic analysis. The MDB in Turkey demonstrated a multifactorial structure, with prominent push factors that are intertwined at macro-meso-micro levels. The effort to maintain the principles of beneficence, non-maleficence, and protecting professional autonomy were the most important in the context of professional ethics. Only deep-rooted regulations might ensure the prevention of the MDB in Turkey and the prospect of doctors returning in the future. Conclusively, the recent criticisms the MDB has been garnering may inspire improvements in deteriorating human and health rights in Turkey.

ETHICAL SENSITIVITY: A COMPARATIVE ANALYSIS OF PHARMACY STUDENTS TAKING AND NOT TAKING AN ETHICS COURSE IN TERMS OF VARIOUS VARIABLES

Objective: The present study aimed to assess ethical sensitivity in second, third, fourth, and fifth-year pharmacy students who have already completed the ethics course in Erzurum province, Turkey, as well as first-year pharmacy students who have not yet taken the ethics course in terms of various variables. Material and Method: This study adopts a cross-sectional design to compare the ethical sensitivity of two groups of pharmacy students: those who have completed an ethics course and those who have not. This study included 476 out of 840 undergraduate pharmacy students from Erzurum province. Differences in ethical sensitivity based on demographic characteristics were analyzed using t-tests and ANOVA. The level of statistical significance was set at 0.05. Result and Discussion: In the comparison between students who have taken the ethics course and those who have not, a statistically significant difference was found between female and male students who have taken the ethics course (p=0.00), indicating that gender plays a role in ethical sensitivity among students who have received ethics education. However, among students who have not taken the ethics course, no statistically significant difference was found between genders (p=0.13). No statistically significant difference was observed among students in different university classes. In the study assessing professional ethical sensitivity among pharmacy students, it was found that their level of ethical sensitivity was above average. To cultivate a heightened level of professional ethical sensitivity, it is widely believed that pharmacy education should integrate more comprehensive training focused on emphasizing the significance of professional behavior and ethical values.

Özel Eğitim Kurumlarında Mesleki Etik Değerlerin İncelenmesi

In this study, it is aimed to examine the professional ethical values in private educational institutions. Although the basic staff in the education of children who require special education is a special education teacher, specially trained staff refers to a team consisting of many different areas of expertise in addition to the teacher. This team will be able to differentiate in the personnel who provide services according to the type of service required by the individual and their requirements. In this context, special education services, special education teachers, teachers assigned special education duties by traveling, guidance counselors-psychological counselors, psychologists, family doctors, audiologists, physiotherapists, parents, volunteer organization officials, primary school inspectors trained in this field, workplace representatives in institutions where individuals requiring special education work can be. Our awareness and experience of our professional actions will provide us with methods for the usefulness of our practices. However, in cases where we remain undecided, when it comes to our conflict with legal sanctions, the lack of someone to consult, even if it is impossible to get out of the business, can put us in front of some dangers. The problems in the field of special education can vary. Curriculum programs that cannot respond to the characteristics of the majority of students can raise the expectations of families, institution managers and education supervisors and cause teachers to make demands on their knowledge and responsibilities. However, staff shortages and teacher characteristics seem to be an obstacle to the formation of working and evaluation conditions that can meet the criteria in professional practices. Parents' failure to provide appropriate support to educational practices and the teacher can sometimes cause the teacher to perceive themselves as inadequate. It is very difficult for teachers to resolve such negative emotions. Because in our country, the number of supervision activities for the development of teachers is almost nonexistent. Key Words: Special Education, Special Educational Institutions, Professional Ethical Values

What do reflective writings of clinical year students say to medical educators?; a qualitative study

ABSTRACT It is aimed to reveal the concepts and values on undergraduate medical education within the clinical students’ reflective writings, and to reveal what the students’ suggestions are to improve medical education in their reflective writings. This is a qualitative study, and the reflective writings of the 5th year students were examined. Qualitative document analysis method was used to evaluate and interpret the data to reveal meaning, gain understanding and develop empirical knowledge. As a result of the content analysis of 192 reflective writings obtained from the students, 8 themes were extracted. Themes covering many important concepts such as self-regulated learning, professional concerns, health literacy, problems related to professional ethical values, effective communication challenges, emotional challenges, limitations in clinical training have emerged. Subjects revealed from reflective writings give medical educators important clues about which topics should be developed in medical education. We think that analyzing reflective writings at regular intervals in the evaluation processes of integrated reflection training programs will provide important data to medical educators on development of undergraduate medical education. Therefore, students’ reflective writing can be an important tool for the development of the curriculum.

Motivational Readiness of Vocational College Teachers for the Innovative Activities

The article deals with the problem of formation of motivational readiness of teachers of vocational colleges. In accordance with the purpose and objectives of the research, the author analyzed regulatory and legal documents, which made it possible to clarify the role and place of innovative activity of teachers of vocational colleges, which refers to one of the types of their professional activity and is carried out within the interaction between research activities. The obtained results serve as a basis for the development and updating of educational programs for the training of specialists for various branches of the economy. Based on the study of the results of research of domestic and foreign scientists’, the content of the innovative activity of teachers of vocational colleges, which is guided in two directions – achieving of innovation in pedagogical practice and the implementation, application and commercialization of the results of scientific research and development in a certain scientific field, was characterized.
 The essence of the motivational readiness of teachers of vocational colleges, which is considered as a mechanism for managing the development of knowledge, practical skills, creative abilities, ways of thinking and special professional qualities, moral and ethical values, which ensures and activates self-development, was determined.
 Two groups of influencing factors on the development of the motivational readiness of teachers of vocational colleges for innovative activities were considered: those related to external conditions (work context) and those related to the content of work. The conditions for the development of the motivational readiness of teachers of vocational colleges for innovative activities were determined and the methodical support of teacher’s training for the innovative and research activities was characterized.

Determinants of nursing students’ inclination to ethical values: Compassionate love and perceived social support from the family

BackgroundSince professional values and the associated behaviors constitute the basis of practice in nursing, which is a profession based on professional ethics and ethical values, it is important to determine the inclination of nurses and nursing students to ethical values and the associated factors. AimIn this study, it was aimed to determine nursing students’ levels of inclination to ethical values, compassionate love and perceived social support from the family, to examine the relationship between sociodemographic characteristics, compassionate love and perceived social support from family and inclination to ethical values, and the determining factors affecting the inclination to ethical values. DesignThis is a descriptive relational study. MethodsThe study was conducted with 558 students studying at the faculty of nursing between April-June 2022. The data were collected face-to-face using the Personal Information Form, Inclination to Ethical Values Scale, Compassionate Love Scale, and Scale of Perceived Social Support from Family. ResultsIt was found that there was a positive and significant relationship between compassionate love and perceived social support from the family and the level of inclination to ethical values, and that the mean scores of compassionate love (β = 0.882) and perceived social support from the family (β = 0.623) explained 89.3% of the change in the level of inclination to ethical values. ConclusionsIt was observed that males, freshman students, those with illiterate parents and students who did not take courses on ethics were in the risky group in terms of inclination to ethical values, and that sociodemographic characteristics, compassionate love and perceived social support from the family were the determinants of inclination to ethical values.

Ethical issues in health care sector: Myth or Reality?

Ethics are the moral duties and responsibilities which govern a lifestyle. In medical profession being ethical is the primary demand, but at times ethical judgement and behaviour may direct towards an unprecedented decision. In these circumstances, medical professionals and health care providers take utmost care to take a diligent decision. But a conflict always exists between the professional and personal ethical values of all health care professionals and workers. At times the health care workers and professionals undergo severe mental distress and agony to respond to professional ethics. The study is conducted with the objective of reviewing ethical issues and conflict existing in the health care sector in the current scenario when the whole world is fighting to defeat the deadly virus of COVID. This paper is based on extensive literature review which includes research articles and papers apart from newspaper articles and reports. The review gave a clear picture on the ethical stature in health care sector. Further, the paper also highlights the ethical issues and conflicts of health care workers and professionals.

Ethical Conflicts Among the Leading Medical and Healthcare Leaders

Today, the whole world is fighting the COVID-19 pandemic. In these circumstances, medical professionals are being viewed as the frontline warriors who are risking their lives for the sake of helping, caring, and curing these patients. However, in these difficult times, there are few medical professionals and health care providers who are taking advantage of this situation and taking advantage of distressed and distraught patients at will. A conflict between professional and personal ethical values makes them depressed and puzzled. It is tough for them to maintain a good image of their profession and business. The objectives of this study are to review the ethical conflict amid the ongoing Covid pandemic and post-Covid pandemic (vaccination period) in the context of medical professionals and health care providers. The paper is designed based on a literature review. Almost fifty-two research papers, articles, survey reports, and newspapers were studied in the context of ethics in business/profession. After reviewing moral distress is ongoing and post-pandemic period, the researchers have tried to present the medical professionals and health care providers' critical situation to give priority to their professional ethics or personal interest.

Designing a Moral Distress Questionnaire in Occupational Therapists and Evaluating Its Face and Content Validities

Objective Moral distress may occur when people are unable to follow professional standards and ethical values in their profession. It is a significant issue in the healthcare profession and has negative consequences. In addition, there is a concern that it may adversely affect clinical performance and, in some cases, patient outcomes. Based on the evidence, occupational therapists experience moral distress, Therefore, there is a need for a tool that enables researchers to identify the extent of moral distress in each individual and to measure the effectiveness of strategies designed to reduce distress and prevent employee burnout. The aim of this study was to develop and evaluate the face and content validity of the Moral Distress Questionnaire in occupational therapists. Materials & Methods This psychometric study was performed in two stages. The first stage involved preparing a pool of questionnaire items, and the second stage examined the face and content validity of the questionnaire. First, texts and related studies were reviewed to extract the questionnaire items. Searching various databases was done to find any conditions that create moral distress in occupational therapy. Three qualitative studies conducted in the field of ethical issues of occupational therapists in the field of psychiatry, children and adults were fully studied. The codes extracted from these studies and the quotations of the interviewees were read. Then the questionnaire items were extracted from the codes, sentences and phrases of the studies. The items were read several times and edited in terms of content clarity, grammar and concept comprehension, and duplicate topics were removed. After preparing the pool of items for the preliminary questionnaire, the scientific stages of face and content validity of the questionnaire were completed. The face validity of the questionnaire was measured qualitatively and quantitatively by 30 occupational therapists who were selected by available sampling from clinics, hospitals and public and private centers. Inclusion criteria were at least one year of work experience in various fields of occupational therapy. Quantitative face validity was performed by determining the impact score of the item. In order to perform qualitative content validity, experts in the field of teaching ethics in occupational therapy and familiar with tool development were invited to review the questionnaire and exchange views in a face-to-face meeting. Seven people participated in the panel of experts. Participants were told that the tool would be an Evaluative tool designed to assess the extent of moral distress among occupational therapists working in clinical settings. After carefully studying the tool, they were asked to consider and comment on the four criteria of clarity, simplicity, transparency, and relevance of items to moral distress. To assess the quantitative content validity of the questionnaire, 20 occupational therapists with doctoral degrees were asked to complete the relevant forms for assessing Content Validity Ratio (CVR) and Content Validity Index (CVI). Results After reviewing the texts and related studies and analyzing the findings and concepts, a preliminary questionnaire with 50 items was extracted. The items of the questionnaire reached 22 items after completing qualitative and quantitative face and content validity. The impact score of the item was between 2.85 to 4.83. The CVR was in the acceptable range of 0.5 to 1 with an average of 0.7. The CVI of the questionnaire was 0.93. Conclusion The Moral Distress Questionnaire in Occupational Therapists with 22 items on a four-point scoring scale has appropriate content validity and can be used to measure moral distress in occupational therapists after completing the validity and reliability steps.

An empirical investigation of the professional identification of sales managers and their ethical intentions

PurposeThe purpose of this study is to show how senior management can create work environments conducive to ethical behavior in organizations through the use of sales managers’ professionalism and professional identification. The study also aims to demonstrate the influence of professional identification in occupations other than those requiring certification.Design/methodology/approachThis study conceptualizes and tests a model using data collected from a survey panel of 350 sales managers. To test the hypotheses, this study makes use of covariance structured analysis.FindingsThe results demonstrate the importance of developing sales managers’ professionalism as an antecedent to professional identification. The findings also show professional identification positively affects professional ethical values, work-related norms and occupational commitment. This study finds that work-related norms moderate the relationship between professional ethical values and ethical intentions and directly and positively influence ethical intentions.Research limitations/implicationsThis study used a panel sampling technique and these findings cannot be generalized to other populations. This study recommends that this study is replicated not only with sales managers but also with other categories of marketers. This study also highlights that more work using methods such as longitudinal panel data and experimentation is required to validate the current findings.Practical implicationsThe findings are of particular interest to senior managers and managers of professional associations, as well as other sales practitioners. Because ethical intentions are affected by work-related norms and from an interaction between work-related norms and professional ethical values, senior managers need to ensure both the work activities in which their staff are involved and the professional ethical values of their employees contribute to appropriate ethical intentions.Originality/valueThis study introduces professional identification into the sales ethics literature and theorize relationships among the professionalism of sales managers and their professional identification, work-related norms, professional ethical values, occupational commitment and ethical intentions. This study empirically measures the professionalism of sales managers.

Development and Validation of an Unethical Professional Behavior Tendencies Scale for Student Teachers.

Teacher’s unethical professional behaviors affect students’ physical and mental health. Prevention should start with student teachers, but empirical research is lacking in China. This study surveyed over 2,000 student teachers from China to examine the psychometric properties of a student teachers’ unethical professional behavior tendencies scale which revised by primary and secondary school teachers’ unethical professional behavior tendencies scale. Exploratory and confirmatory factor analysis confirmed that a bi-factor model fit the data best. The final student teachers’ unethical professional behavior tendencies scale comprised four subscales, including a general factor (unethical professional behaviors) and four special factors (perfunctory attitude and carelessness, insults and discrimination, unfairness, and using power for personal gain). The student teachers’ unethical professional behavior tendencies scale correlated negatively with their professional ethical values and positively with perceived frequency of unethical professional behaviors of college teachers around them. The data supported the scale’s measurement invariance across gender, and male student teachers scored significantly higher on unethical professional behavior tendencies than female student teachers. The findings suggest that the student teachers’ unethical professional behavior tendencies scale is a useful instrument for assessing student teachers’ unethical professional behaviors in China.

Empowering professional and ethical balance in digital record management

PurposeThis paper aims to examine the professional skills and ethical values balanced to generate policies and procedures with significant guidance to give insights into systematic control of integrating simultaneous integrity between the use and maintenance in digital-based recordkeeping.Design/methodology/approachThe investigation was conducted using keywords responsibilities engagement, professional and ethical balance, and records management. Descriptive analysis was applied with the initiative on integrating, evaluating and interpreting the findings of multiple types of research from recent grounded theory.FindingsThe finding reveals that determining the potential value of foregoing effort to provide an ultimate application guideline as a counter measure against the emerging challenges of the dynamic records management system needs to adopt appropriate professional and ethical empowerment across the procedural stage in underlying the demand and the response with the express purpose of promoting appropriate and wise usage for the sustainable positive benefit of responsibilities on recording management.Originality/valueAs a pivotal role in determining the potential value of foregoing effort as aimed in this paper, the initiative to provide an ultimate application guideline as a counter measure against the emerging challenges of the dynamic records management system needs to bring along with urging for an appropriate professional and ethical empowerment across the procedural stage proposed referring to the demand and the response with the express purpose of promoting appropriate and wise usage for the sustainable positive benefit of responsibilities on recording management.

Factors Affecting Professional Integrity in Nurses: A Qualitative Content Analysis

Background: Integrity is one of the professional values mentioned in the ethical codes of the ProfessionalNursing Association. It is defined as a commitment to the five fundamental values of integrity, trust, equality,respect, and accountability. This study aims to explore factors affecting professional integrity in nurses.Methods: A descriptive content analysis was carried out by 17 interviews with Iranian nurses who werechosen through purposive sampling. The data collection instruments were semi-structured interviewsand observation. The interviews were recorded and transcribed word by word; then, they were coded andanalyzed by Graneheim and Lundman qualitative content analysis method. For the trustworthiness of thestudy, Guba and Lincoln’s criteria were used.Result: After analysis, the latent meanings formulated into one theme,” keeping up confident beliefs,” whichconsists of “religious beliefs,” “inner call,” “philanthropic sense,” “empathetic care” and “divine rewards”categories.Conclusion: Many factors are heading to internalizing professional integrity in nurses in Iran. Authorities,managers, and faculty members should pay special attention to the internalization of professional integrityand ethical values, such as altruism, conscience, empathy, and the presence of God in life to decrease themistakes and promote quality of care.

Perceptions of a Group of Medical Students Regarding the Issue of Abortion: A Qualitative Analysis.

Aim: The medical ethics education given at the faculty of medicine aims to help prospective physicians develop an ethics awareness as part of their professional identity so that they can evaluate the determinants of patient-physician relationship, identify the ethical issues and problems prevailing in medical practice and researches, and find appropriate solutions to the ethical dilemmas faced while protecting ethical values. The objective of this study was to set forth the perceptions of a group of medical students at Hacettepe University regarding the issue of abortion on the basis of the movie If These Walls Could Talk. We aimed to take students’ opinions on abortion, help them ponder on this issue within the context of professional values of physicians, and investigate whether they have gained a critical perspective in terms of feminist bioethics within the framework of the elective courses “Bioethics and Cinema” and “Representation of Physicians in Cinema”, both of which were offered during undergraduate medical education at Faculty of Medicine, Hacettepe University. Method: The assignments submitted by 178 medical students about the movie “If These Walls Could Talk”, which is used as an educational course material at the Department of Medical History and Ethics, Hacettepe University, were evaluated using thematic analysis method. Before conducting the analyses of the assignments, the necessary permissions for the research were obtained from the Ethics Commission of Hacettepe University on 26.05.2017 with the approval numbered 3861. Findings: The data obtained from student assignments were categorized into main and sub themes. The themes determined upon evaluating the students’ perceptions on abortion were “Human Rights”, “Ethical Justification”, and “The Role of Society”. Conclusion and Suggestions: Our findings have demonstrated that the students have gained awareness on both personal values and professional ethical values. It can be said that the students could discuss abortion – which is an important issue of debate in bioethics – with a feminist bioethics perspective and using their critical thinking skills. Therefore, we suggest that film screenings and follow-up film debates be utilized more often in medical ethics/bioethics education.

Valence–Instrumentality–Expectancy Model of Motivation as an Alternative Model for Examining Ethical Leadership Behaviors

Incessant occurrences of character failure of people in leadership positions that have characterized organizations in recent years call for critical examination of leadership behaviors. The Social Learning Theory and Trickle-Down Model are some of the common approaches previously used to analyze ethical leadership behaviors. However, the challenges with how these models inspire ethical behaviors call for further examination of the issue. Using a multidisciplinary integrative literature review, we present Vroom’s Valence–Instrumentality–Expectancy (VIE) Model of Motivation as an alternative model for examining ethical leadership behaviors. The VIE Model provides clarity regarding how leaders are motivated to behave ethically. We utilize ideas from the VIE model in conjunction with Starratt’s Three-Step Approach to develop a unique framework for examining ethical leadership behaviors. Our model highlights the importance of a leader’s values in creating organizational ethical values that eventually translate into professional ethical values. Using the motivational approach to inspire ethical leadership will drive organizational members to internalize ethical behavior as a conviction rather than complying with a set rule.

Business managers in children’s playground : Exploring a problematic (or not!) identity construction of early childhood teachers in New Zealand

The impacts of neo-liberal education reforms on the early childhood education sector have been a focal point of scholarly critiques in New Zealand. Interestingly, only a few studies have addressed how teacher professional identities and professionalism have changed in response to the neo-liberal context of New Zealand early childhood education. It has been, however, recognised that understanding the complexity of teacher professional identities within the rapidly transforming landscape of early childhood education is a key consideration in implementing and sustaining a change agenda in education policies and practices. In this article, the author draws on data from her research study about how teachers’ professional identities have been reconstructed in response to the shifting discourses in New Zealand early childhood education policies and practices. Specifically, the author explores the construction of teachers as business managers, which has emerged through an interplay of discourses of marketisation and privatisation driving some of the country’s early childhood education policies and practices. It is argued that the construction of teachers as business managers has altered core professional ethical values underpinning the teaching profession, professionalism and the purpose of early childhood education in New Zealand, which were traditionally embedded in discourses of collective democracy, equity and social justice.

The Lecturers’ Belief on Ethics and Professional Moral Values in Teaching Practice

The soft skills module that was introduced in 2006 is aimed to prepare graduates with a holistic quality for industrial or labour market needs. As a result, the lecturers are required to integrate the element of soft skills in their respective teaching. However, reports on the application of soft skills in teaching identified the element of professional ethical and moral values ​​(NEMPs) was the least emphasis element for a lecturer. Lack of skills to apply these values, time constraints in completing the course syllabus and absence of referral documents are identified factors that caused the problems. Thus, this study explores the beliefs of six selected lecturers on their ethics and professional moral values in teaching practice. The research data was obtained through semi-structured interviews and analysed using Atlas.ti to obtain key themes which then could be used as a guide in implementing the application of ethical and moral values ​​in teaching.
 Keywords: Ethics, Values education, Soft skills, Teaching, Moral values.

PROFESSIONAL SKEPTICISM AND ETHICS IN TERMS OF ACCOUNTING

Etik kavramı; iyiyi-kötüden, doğruyu-yanlıştan, faydalıyı-zararlıdan ayıran uyulması gereken ilke ve kuralların bütünü olacak şekilde ifade edilmektedir. Mesleki şüphecilik ise mesleki etik çerçevesinde denetçi ve meslek mensubunun finansal tablolarda oluşabilecek hata ve hilelerin ortaya çıkarılabilmesi için önemlidir. Muhasebede etik ilkelerine sahip olan meslek mensuplarının güvenilir, yeterli ve bağımsız karar alabilme ile birlikte kendilerini denetleme özelliklerine sahip olması gerekmektedir. Bu noktada mesleki özenin gerektirdiği sorgulayıcı akıl ve septik düşünce doğrultusunda denetim kanıtlarının dikkatli olarak hazırlanması önemlidir.Bu çalışmada, mesleki şüpheciliğin etik algısı üzerindeki etkisinin incelenmesi amaçlanmaktadır. Bu amaca yönelik olarak Uşak ilinde faaliyet gösteren Serbest Muhasebeci Mali Müşavir (SMMM) unvanına sahip meslek mensuplarına anket uygulanmıştır. Anket uygulamasından elde edilen veriler; betimleyici analiz, açıklayıcı faktör analizi, doğrulayıcı faktör analizi ve yapısal eşitlik modeli ile analiz edilmiştir. Çalışma sonucunda muhasebe açısından mesleki şüpheciliğin mesleki etik değerleri üzerinde aynı yönlü etkisi olduğu bulunmuştur.

Moral distress perspectives among interprofessional intensive care unit team members.

To examine interprofessional healthcare professionals' perceptions of triggers and root causes of moral distress. Qualitative description of open-text comments written on the Moral Distress Scale-Revised survey. A subset of interprofessional providers from a parent study provided open-text comments that originated from four areas of the Moral Distress Scale-Revised, including the margins of the 21-item questionnaire, the designated open-text section, shared perceptions of team communication and dynamics affecting moral distress, and the section addressing an intent to leave a clinical position because of moral distress. Open-text comments were captured, coded, and divided into meaning units and themes using systematic text condensation. Twenty-eight of the 223 parent study participants completing the Moral Distress Scale-Revised shared comments on situations contributing to moral distress. All 28 participants working in the four medical center intensive care units reported feelings of moral distress. Feelings of moral distress were associated with professional anguish over patient care decisions, team, and system-level factors. Professional-level contributors reflected clinician concerns of continuing life support measures perceived not in the patient's best interest. Team and unit-level factors were related to poor communication, bullying, and a lack of collegial collaboration. System-level factors included clinicians feeling unsupported by senior administration and institutional culpability as a result of healthcare processes and system constraints impeding reliable patient care delivery. Approval was obtained from the Institutional Review Board (IRB) of the University of Texas Health IRB and the organization in which the study was conducted. Moral distress was associated with feelings of anguish, professional intimidation, and organizational factors that impacted the delivery of ethically based patient care. Participants expressed a sense of awareness that they may experience ethical dilemmas as a consequence of the changing reality of providing healthcare within complex healthcare systems. Strategies to combat moral distress should target team and system interventions designed to improve interprofessional collaboration and support professional ethical values and moral commitments of all healthcare providers.