Between duty and constraint: a qualitative systematic review of healthcare providers' ethical challenges and moral stressors in caring for undocumented migrants
Systematic review reveals ethical conflicts and moral stressors in providers caring for undocumented migrants, suggesting need for structural changes.
Key Points
This review aims to synthesize qualitative studies on the ethical challenges and moral stressors faced by healthcare providers caring for undocumented migrants.
Systematic review following PRISMA guidelines of PubMed, Embase, CINAHL, and Cochrane Library for qualitative studies.
Inclusion/exclusion criteria were applied to screen studies based on title, abstract, and full text.
Quality was assessed using the CASP checklist and data was synthesized following the Qualitative Analysis Guide of Leuven (QUAGOL).
Identified 37 qualitative studies leading to 58 themes organized into five key concepts: experiences, perceptions, attitudes, practices, and coping mechanisms.
Providers reported moral distress, emotional exhaustion, and dilemmas due to legal constraints and conflicting professional obligations.
Key ethical tensions include beneficence vs. non-maleficence and professional duty vs. legal compliance, with ethical burden-shifting identified as a central theme.