Marcel and Josephine Patterson Memorial Lecture in the Medical Humanities

Perceptions of Vulnerability and Moral
Distress in Neurological Care

Georgina Morley, PhD, MSc, RN (UK)
Nurse Ethicist, Assistant Staff
Director, Nursing Ethics Program
Assistant Professor
Cleveland Clinic
Lerner College of Medicine

Thursday, October 21, 2021

12:00 p.m.—1:00 p.m.

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A free Social Work CEU will be offered for this presentation. After the presentation,
please reach out to Savannah Parks at sjparks@utmb.edu to claim your CEU.

 Using case studies, we explore ethical complexities commonly arising in neurological care that compound moral distress. First, we analyze obstacles to shared decision-making for patients at the margins of decision-making capacity or whose capacity fluctuates over the course of their clinical care, and the moral distress that can arise when there are incapacitated refusals of care. Second, we explore situations in which cognitive impairments present a possible contraindication to life-prolonging interventions. We identify compounding factors likely to exacerbate moral distress in neurological care, including epistemic injustices, communication barriers, and the perceived vulnerability of patients with neurological conditions. explore connections between sources of vulnerability identified in Kenneth Kipnis’ bioethical taxonomy of vulnerability and heightened moral distress amongst healthcare professionals. We conclude with recommendations to mitigate moral distress that may arise in caring for cognitively vulnerable patient populations.