Education in ethics is essential for health care workers. Despite mandated ethics education in medical and nursing curricula within Australia and New Zealand, there remains little consistency in format, delivery, or assessment of education. How healthcare workers recognise and respond to ethical challenges in real-world practice remains underexplored. The frequency of experiencing moral distress is significant, particularly among junior doctors and nurses, with triggers including perceived futility, constrained clinical autonomy, and conflicting personal and professional views. We employed a qualitative design to better understand how health professionals experience ethical encounters in their daily practice and how prepared they are to engage with ethical dimensions of patient care. We examine the role of institutional context in shaping ethical awareness while identifying knowledge gaps to inform future ethics training and support requirements. Focus groups were conducted with n-26 health professionals in Australia. Data were collected in August 2024. Qualitative analyses were used to develop themes and are presented in a descriptive framework. The study is reported in line with Consolidated Criteria for Reporting Qualitative Research (COREQ). Healthcare workers in this study readily identified the place of ethics in their clinical work. Recognition or awareness of ethics emerged through reflection on their own actions and through collaboration with others. Feelings of voicelessness or powerlessness gave rise to moral distress. Heuristics were often deployed to navigate complexity in ethical encounters. Participants felt prepared to deal with the ethical dimensions of work when they participated in constructive collaboration, had sufficient information and practical experience. The institutional context for ethics was understood as both supportive and as a hinderance. Demarcated responsibilities between professional groups can create challenges while systemic factors, such as financial constraints, also provided challenges and factored into ethical decision making. Ethics is a routine feature of care, recognised in moments of uncertainty, disagreement, and constrained decision-making. Exposure to previous formal ethics education varied but was commonly minimal, poorly recalled, or weakly connected to real-time decision-making needs. We argue for greater attention to ethics support for health professionals to aid decision making and reduce distress.
Durkin et al. (Wed,) studied this question.