Within this paper, we discuss Moral Distress Reflective Debriefs as a promising approach to address and mitigate moral distress experienced by healthcare professionals. We briefly review the empirical and theoretical literature on critical incident stress debriefing and psychological debriefing to highlight the potential benefits of this modality. We then describe the approach that we take to facilitating reflective group discussions in response to morally distressing patient cases (“Moral Distress Reflective Debriefs”). We discuss how the debriefing literature and other clinical ethics activities influenced the development of our approach. In particular, we focus on the role of the clinical ethicist as a facilitator with particular emphasis on encouraging perspective-taking and nurturing ethical attunement in a supportive manner. We suggest that this approach reduces the narrowing effects of frustration and anger that are often reported when individuals experience moral-constraint distress. Finally, we provide an example of Moral Distress Reflective Debriefs, elucidating how this supportive process complements ethics consultation and can mitigate the negative effects of moral distress.

在本文中，我们讨论了道德困境反思性汇报作为解决和减轻医疗保健专业人员所经历的道德困境的一种有前途的方法。我们简要回顾了关于关键事件压力汇报和心理汇报的实证和理论文献，以强调这种方式的潜在好处。然后，我们描述了我们采取的方法来促进反思性小组讨论，以应对道德上令人痛苦的患者案例（“道德困境反思性汇报”）。我们讨论了汇报文献和其他临床伦理活动如何影响我们方法的发展。特别是，我们关注临床伦理学家作为促进者的作用，特别强调以支持的方式鼓励换位思考和培养伦理调和。我们建议，这种方法可以减少挫折和愤怒的缩小效果，当个人经历道德约束困扰时，通常会报告这些效果。最后，我们提供了一个道德困境反思性汇报的例子，阐明了这种支持过程如何补充道德咨询并可以减轻道德困境的负面影响。