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Burnout in palliative care: an ethical perspective
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Burnout refers to a loss of energy, which usually happens when the person feels “burned”, either in physical and psychological terms. A burned out person evidences signs of distress in his/her daily behaviour, and it turns to be almost impossible to function normally due to exhaustion. Repeated contact with suffering, dying and death and the need to face ethical challenges and dilemmas due to professional practice in palliative care may be stressful, demanding and a risk factor for burnout. Despite this fact, from a study conducted between September 2008 and July 2009, we realized that burnout levels in Portuguese nurses and physicians who work in palliative care teams were low. One of the main protective factors enounced during interviews and observations was an ethic of care in the relation professionals have with patients, relatives and also between professionals. Aims: (i) to build an ethical perspective of burnout syndrome in palliative care; (ii) to enounce the main ethical dilemmas considered by Portuguese physicians and nurses who work in palliative care; (iii) to reveal the ethic of care as a protective factor for burnout in palliative care; (iv) to consider the ethical principle of responsibility as a demand for burnout prevention. Results: Although burnout is commonly studied by psychologists, it seems clear that it has en ethical perspective in a triple dimension: first, due to its consequences, both for patients and relative as for professionals themselves; second, due to the ethic of care as one of the most relevant protective factors that contribute to avoid burnout; third, due to the ethical demand in order to develop active strategies that prevent burnout, which is simultaneously an individual, team and organizational responsibility. Conclusion: Our results structure an ethical view for burnout syndrome in palliative care, related to its risk and protective factors and also to the active prevention strategies used by palliative care teams.