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Paper Presentation

Clinical Ethics

Session: Moral Distress

Navigating Systemic Barriers: The Impact of Socioeconomic Constraints on Clinical Ethicists

Thursday, October 23, 2025
10:30 AM - 11:30 AM Pacific Time
Location: C123
Cíntia Engel, PhD – Universidade do Goiás; Jeffrey Farroni, PhD, JD – University of Texas Medical Branch; Emma Tumilty, PhD – University of Texas Medical Branch
Abstract: Clinical ethicists navigate complex ethical dilemmas to support patients, families, and healthcare teams in making difficult decisions. However, in many cases, they must also contend with structural and socioeconomic constraints within a patient’s case, such as lack of insurance, financial hardship, or limited access to necessary care.

Research indicates that healthcare professionals can experience moral distress when systemic barriers prevent them from providing what they consider good care. While the literature explores how to offer ethical guidance in the face of socioeconomic limitations, there is little understanding of how these constraints professionally and personally affect clinical ethicists. The emotional and ethical burden ethicists carry in such situations remains underexplored.

The perspectives of clinical ethicists provide valuable insight into the ethical complexities of navigating systemic inequities during clinical ethics consultations. In this presentation, we discuss a research project that examines how socioeconomic constraints impact clinical ethics consultants and what strategies they employ to cope with potential moral distress. We will share preliminary findings from 78 valid survey responses and 15 completed in-depth semi-structured interviews, shedding light on the personal and professional implications of clinical ethicists working within these constraints and the profession’s role in addressing these broader limitations. We explore issues like whether clinical ethicists should address socioeconomic constraints in patient cases and what responsibility, if any, the profession has to advocate for systemic level changes that impact social and economic constraints in healthcare.

Keywords: Moral Distress, Socioeconomic barriers, Clinical ethics consultation

Learning Objectives:

After participating in this conference, attendees should be able to:
  • Understand the socioeconomic barriers clinical ethicists encounter during consultations and the impact they have on the individual consultants.
  • Discuss clinical ethicists strategies for coping with potential moral distress from systemic inequities in healthcare.