Surreal Becomes Real: Ethical Dilemmas Related to the COVID-19 Pandemic and Professional Identity Formation of Health Professionals

Abstract

Fundamental quandaries of clinical and biomedical ethics for health care professionals, committees, and systems have been raised into stark relief by the COVID-19 pandemic. The nature and extent of critical issues raised by this ongoing crisis, including challenging ethical dilemmas for the health care profession, is likely to have an indelible impact on the professional identity formation (PIF) of learners and practitioners across the trajectory of the professional lifecycle. The lifelong process of PIF for health care practitioners, from learner through independent practice, is supported in medical education by intentional reflection, relationships within community of practice include guidance from mentoring, as well as resilience, both emotional and moral. We consider how grappling with ethical dilemmas related to the COVID-19 pandemic can challenge, inform, and even potentially transform the PIF process, thereby supporting development of a morally resilient, humanistic professional identity in health care trainees and health care professionals.

The paradox of the impact of the COVID-19 pandemic on massage therapists in Australia and Canada: The reporting of a qualitative strand of a mixed methods study

“…While moral distress is not new for other professions ( Guzys, 2021 ), this is not something common to massage therapists' experience of practice, except in specialized areas of care, such as oncology massage. Thus, many massage therapists have not been educated about moral distress, how to recognise it or how to manage it when it occurs, nor had the opportunity to build moral resilience, which is ‘the capacity to sustain or restore moral integrity in response to moral complexity, confusion, distress, or setbacks’ ( Wald and Ruddy, 2021 , p. 59). Unresolved moral distress can challenge therapists' moral resilience and subsequently, critically influence therapists' professional identity ( Wald and Ruddy, 2021 ).…”

“…Thus, many massage therapists have not been educated about moral distress, how to recognise it or how to manage it when it occurs, nor had the opportunity to build moral resilience, which is ‘the capacity to sustain or restore moral integrity in response to moral complexity, confusion, distress, or setbacks’ ( Wald and Ruddy, 2021 , p. 59). Unresolved moral distress can challenge therapists' moral resilience and subsequently, critically influence therapists' professional identity ( Wald and Ruddy, 2021 ). As the pandemic continues, so does the potential for further episodes of moral distress and the complications that arise from moral distress such as depression, anxiety, post-traumatic stress disorder and burnout ( Plouffe et al, 2021 ; Wilson et al, 2022 ).…”

Identity Development in Disorientating Times: the Experiences of Medical Students During COVID-19

“…Complex interactions like these signify transition from Kegan’s socialized lens, where students may succumb to peer pressure, to a self-authoring lens, where an internal sense of direction guided by values rooted in social responsibility is established [ 46 ]. Wald and Ruddy speculate that dealing with dilemmas during COVID-19, such as one’s own commitment to the medical profession, may support the development of ‘a morally resilient, humanistic’ identity [ 47 ]. Our research supports this suggestion, as development of students’ identities as agentic advocates within non-healthcare settings acted to catalyze student identity development through the stages of Kegan’s model, to more developed levels than previously reported within medical students [ 22 ].…”

The Making of an Educator: Professional Identity Formation Among Graduate Medical Education Faculty Through Situated Learning Theory

“…2 The ongoing health crisis presents parallel challenges to professional development among learners and educators alike. 3 This raises the question: how should medical professionals be educated and trained to assimilate and enact these roles?…”