{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T08:42:52Z","timestamp":1781599372929,"version":"3.54.5"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Ethics"],"DOI":"10.1186\/s12910-025-01330-1","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T15:44:02Z","timestamp":1764171842000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Navigating crisis: a qualitative exploration of medical social workers\u2019 responses to ethical issues during COVID-19"],"prefix":"10.1186","volume":"26","author":[{"given":"Abhirupa","family":"Dasgupta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia E.","family":"Allen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon R.","family":"Power","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany R.","family":"Washington","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terri D.","family":"Lewinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"issue":"S3","key":"1330_CR1","doi-asserted-by":"publisher","first-page":"S236","DOI":"10.2105\/AJPH.2017.304005","volume":"107","author":"BJ Ruth","year":"2017","unstructured":"Ruth BJ, Marshall JW. A history of social work in public health. Am J Public Health. 2017;107(S3):S236\u201342.","journal-title":"Am J Public Health"},{"issue":"6","key":"1330_CR2","doi-asserted-by":"publisher","first-page":"S281","DOI":"10.1016\/j.amepre.2018.01.046","volume":"54","author":"EP Fraher","year":"2018","unstructured":"Fraher EP, Richman EL, Zerden LDS, Lombardi B. Social work student and practitioner roles in integrated care settings. Am J Prev Med. 2018;54(6):S281-9.","journal-title":"Am J Prev Med"},{"issue":"1","key":"1330_CR3","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1111\/ijsw.12469","volume":"30","author":"L Dominelli","year":"2021","unstructured":"Dominelli L. A green social work perspective on social work during the time of COVID-19. Int J Soc Welfare. 2021;30(1):7\u201316.","journal-title":"Int J Soc Welfare"},{"issue":"2","key":"1330_CR4","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12020174","volume":"12","author":"T Washington","year":"2024","unstructured":"Washington T, Lewinson TD. Healthcare social workers\u2019 scope of practice during COVID-19. Healthcare. 2024;12(2):174.","journal-title":"Healthcare"},{"key":"1330_CR5","doi-asserted-by":"crossref","unstructured":"Power SR, Washington TR, Lewinson TD. Talk to the tablet: technology\u2019s impact on medical social work practice during COVID-19. J Technol Hum Serv. 2024;42(3):194\u2013214.","DOI":"10.1080\/15228835.2024.2343687"},{"issue":"6\u20137","key":"1330_CR6","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1080\/00981389.2023.2221718","volume":"62","author":"TD Lewinson","year":"2023","unstructured":"Lewinson TD, Washington TR, Allen SE, Murphey JM, Onsando WM. We\u2019re kind of on the back burner: psychological distress and coping among medical social workers during the COVID-19 pandemic. Soc Work Health Care. 2023;62(6\u20137):243\u201362.","journal-title":"Soc Work Health Care"},{"issue":"1","key":"1330_CR7","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1080\/00981389.2021.1885565","volume":"60","author":"AM Ross","year":"2021","unstructured":"Ross AM, Schneider S, Muneton-Castano YF, Caldas AA, Boskey ER. You never stop being a social worker: experiences of pediatric hospital social workers during the acute phase of the COVID-19 pandemic. Soc Work Health Care. 2021;60(1):8\u201329.","journal-title":"Soc Work Health Care"},{"key":"1330_CR8","unstructured":"National Association of Social Workers. Highlighted Revisions to the Code of Ethics. NASW. 2021. Available from: https:\/\/www.socialworkers.org\/About\/Ethics\/Code-of-Ethics\/Highlighted-Revisions-to-the-Code-of-Ethics."},{"key":"1330_CR9","unstructured":"National Association of Social Workers. 1976 Code of Ethics. 1967. Available from: https:\/\/www.socialworkers.org\/LinkClick.aspx?fileticket=9PxSwiQrItA%3d&portalid=0."},{"key":"1330_CR10","unstructured":"National Association of Social Workers. History of the NASW Code of Ethics. 2017. Available from: https:\/\/www.socialworkers.org\/About\/Ethics\/Code-of-Ethics\/History#:~:text=NASW\u2019s%20Delegate%20Assembly%20approved%20the,fourteen%20responsibilities%20for%20social%20workers."},{"issue":"3","key":"1330_CR11","doi-asserted-by":"publisher","first-page":"1724","DOI":"10.1093\/bjsw\/bcab158","volume":"52","author":"R Ashcroft","year":"2022","unstructured":"Ashcroft R, Sur D, Greenblatt A, Donahue P. The impact of the COVID-19 pandemic on social workers at the frontline: a survey of Canadian social workers. Br J Soc Work. 2022;52(3):1724\u201346.","journal-title":"Br J Soc Work"},{"issue":"3","key":"1330_CR12","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1177\/14680173211013243","volume":"22","author":"JJ Miller","year":"2022","unstructured":"Miller JJ, Grise-Owens E. The impact of COVID-19 on social workers: an assessment of peritraumatic distress. J Soc Work. 2022;22(3):674\u201391.","journal-title":"J Soc Work"},{"issue":"6","key":"1330_CR13","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1080\/13691457.2020.1870215","volume":"24","author":"P Frieiro Pad\u00edn","year":"2021","unstructured":"Frieiro Pad\u00edn P, Verde-Diego C, Arias TF, Gonz\u00e1lez-Rodr\u00edguez R. Burnout in health social work: an international systematic review (2000\u20132020). Eur J Soc Work. 2021;24(6):1051\u201365.","journal-title":"Eur J Soc Work"},{"issue":"3","key":"1330_CR14","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1080\/09638230020023642","volume":"11","author":"C Lloyd","year":"2002","unstructured":"Lloyd C, King R, Chenoweth L. Social work, stress and burnout: a review. J Ment Health. 2002;11(3):255\u201365.","journal-title":"J Ment Health"},{"issue":"1","key":"1330_CR15","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1080\/19371918.2024.2427759","volume":"40","author":"VC Watson","year":"2025","unstructured":"Watson VC, Begun S. Burnout in social work: a review of the literature within the context of COVID-19. Soc Work Public Health. 2025;40(1):19\u201330.","journal-title":"Soc Work Public Health"},{"issue":"2","key":"1330_CR16","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1080\/19371918.2022.2097973","volume":"38","author":"L Ventura","year":"2023","unstructured":"Ventura L, Chiarelli-Helminiak CM, Frankel AS, Hipple E, Ibrahim J, Sharma S, et al. Unprecedented times: experiences of social work and public health professionals during times of public crises. Soc Work Public Health. 2023;38(2):121\u201334.","journal-title":"Soc Work Public Health"},{"issue":"4","key":"1330_CR17","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1017\/S1478951522001341","volume":"21","author":"A Latimer","year":"2023","unstructured":"Latimer A, Fantus S, Pachner TM, Benner K, Leff V. Palliative and hospice social workers\u2019 moral distress during the COVID-19 pandemic. Palliat Support Care. 2023;21(4):628\u201333.","journal-title":"Palliat Support Care"},{"issue":"1","key":"1330_CR18","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1007\/s41134-020-00150-0","volume":"6","author":"C Bernhardt","year":"2021","unstructured":"Bernhardt C, Forgetta S, Sualp K. Violations of health as a human right and moral distress: considerations for social work practice and education. J Hum Rights Soc Work. 2021;6(1):91\u20136.","journal-title":"J Hum Rights Soc Work"},{"key":"1330_CR19","first-page":"331","volume-title":"Nursing practice: the ethical issues","author":"A Jameton","year":"1984","unstructured":"Jameton A. Nursing practice: the ethical issues. Englewood Cliffs, NJ: Prentice-Hall; 1984. p. 331."},{"issue":"1","key":"1330_CR20","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1093\/bjsw\/bcac206","volume":"53","author":"S Fantus","year":"2023","unstructured":"Fantus S, Cole R, Hawkins L, Chakraborty P. Have they talked about Us at All?\u2019 the moral distress of healthcare social workers during the COVID-19 pandemic: a qualitative investigation in the state of Texas. Br J Soc Work. 2023;53(1):425\u201347.","journal-title":"Br J Soc Work"},{"issue":"7","key":"1330_CR21","doi-asserted-by":"publisher","first-page":"3053","DOI":"10.1093\/bjsw\/bcae078","volume":"54","author":"AM Palma Contreras","year":"2024","unstructured":"Palma Contreras AM, Pardo Adriasola MA. Moral distress in social work: a systematic literature review. Br J Soc Work. 2024;54(7):3053\u201372.","journal-title":"Br J Soc Work"},{"issue":"5","key":"1330_CR22","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1177\/0020872820949614","volume":"63","author":"S Banks","year":"2020","unstructured":"Banks S, Cai T, De Jonge E, Shears J, Shum M, Sobo\u010dan AM, et al. Practising ethically during COVID-19: social work challenges and responses. Int Soc Work. 2020;63(5):569\u201383.","journal-title":"Int Soc Work"},{"key":"1330_CR23","unstructured":"Lumivero. NVivo 14. Lumivero; 2023. (NVivo).\u00a0https:\/\/lumivero.com\/legal-information\/usage-guidelines\/."},{"key":"1330_CR24","first-page":"303","volume-title":"The coding manual for qualitative researchers","author":"J Salda\u00f1a","year":"2013","unstructured":"Salda\u00f1a J. The coding manual for qualitative researchers. 2nd ed. Los Angeles: SAGE; 2013. p. 303.","edition":"2"},{"issue":"2","key":"1330_CR25","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1080\/10437797.2021.1895932","volume":"58","author":"J DeMarchis","year":"2022","unstructured":"DeMarchis J, Friedman L, Eyrich Garg K. An ethical responsibility to instill, cultivate, and reinforce self-care skills. J Soc Work Educ. 2022;58(2):308\u201316.","journal-title":"J Soc Work Educ"},{"issue":"3","key":"1330_CR26","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1080\/01488376.2019.1566195","volume":"46","author":"J Bae","year":"2020","unstructured":"Bae J, Jennings PF, Hardeman CP, Kim E, Lee M, Littleton T, et al. Compassion satisfaction among social work practitioners: the role of work\u2013life balance. J Soc Serv Res. 2020;46(3):320\u201330.","journal-title":"J Soc Serv Res"},{"issue":"6","key":"1330_CR27","doi-asserted-by":"publisher","first-page":"1927","DOI":"10.1093\/bjsw\/bcp137","volume":"40","author":"R Dekel","year":"2010","unstructured":"Dekel R, Baum N. Intervention in a shared traumatic reality: a new challenge for social workers. Br J Soc Work. 2010;40(6):1927\u201344.","journal-title":"Br J Soc Work"},{"key":"1330_CR28","doi-asserted-by":"publisher","DOI":"10.1177\/09697330241230519","author":"S Fantus","year":"2024","unstructured":"Fantus S, Cole R, Usset TJ, Hawkins LE. Multi-professional perspectives to reduce moral distress: a qualitative investigation. Nurs Ethics. 2024. https:\/\/doi.org\/10.1177\/09697330241230519.","journal-title":"Nurs Ethics"},{"issue":"5","key":"1330_CR29","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1097\/01.NAJ.0000830744.96819.d","volume":"122","author":"F Pagador","year":"2022","unstructured":"Pagador F, Barone M, Manoukian M, Xu W, Kim L. Effective holistic approaches to reducing nurse stress and burnout during COVID-19. Am J Nurs. 2022;122(5):40\u20137. https:\/\/doi.org\/10.1097\/01.NAJ.0000830744.96819.d.","journal-title":"Am J Nurs"},{"issue":"3","key":"1330_CR30","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1177\/19375867231151243","volume":"16","author":"SJ Bosch","year":"2023","unstructured":"Bosch SJ, Valipoor S, Alakshendra A, et al. Coping and caregiving: leveraging environmental design to moderate stress among healthcare workers in the emergency department setting. HERD. 2023;16(3):261\u201377. https:\/\/doi.org\/10.1177\/19375867231151243.","journal-title":"HERD"},{"issue":"2","key":"1330_CR31","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1080\/19371918.2021.1981509","volume":"37","author":"M Garcia","year":"2022","unstructured":"Garcia M. This is america: systemic racism and health inequities amidst the COVID-19 pandemic. Soc Work Public Health. 2022;37(2):105\u201321.","journal-title":"Soc Work Public Health"},{"issue":"2","key":"1330_CR32","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021-052883","volume":"149","author":"EC Kibakaya","year":"2022","unstructured":"Kibakaya EC, Oyeku SO. Cultural humility: a critical step in achieving health equity. Pediatrics. 2022;149(2):e2021052883.","journal-title":"Pediatrics"},{"key":"1330_CR33","volume":"12","author":"MF Elbanna","year":"2023","unstructured":"Elbanna MF, Thomas MR, Patel PR, McHenry MS. Cultivating cultural humility to address the healthcare burnout epidemic\u2013why it matters. Glob Adv Integr Med Health. 2023;12:275361302311623.","journal-title":"Glob Adv Integr Med Health"},{"key":"1330_CR34","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjep.2019.100282","volume":"17","author":"BV Sweet","year":"2019","unstructured":"Sweet BV, Fischer DJ, Khang EM. Incorporating grand rounds into an existing pharmacy ethics course: an interprofessional education opportunity. Journal of Interprofessional Education & Practice. 2019;17:100282.","journal-title":"Journal of Interprofessional Education & Practice"},{"issue":"4","key":"1330_CR35","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1111\/scs.12922","volume":"35","author":"L Lindwall","year":"2021","unstructured":"Lindwall L, Lohne V. Human dignity research in clinical practice \u2013 a systematic literature review. Scand J Caring Sci. 2021;35(4):1038\u201349.","journal-title":"Scand J Caring Sci"},{"issue":"5","key":"1330_CR36","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1177\/02692163211004228","volume":"35","author":"L Mitchinson","year":"2021","unstructured":"Mitchinson L, Dowrick A, Buck C, Hoernke K, Martin S, Vanderslott S, et al. Missing the human connection: A rapid appraisal of healthcare workers\u2019 perceptions and experiences of providing palliative care during the COVID-19 pandemic. Palliat Med. 2021;35(5):852\u201361.","journal-title":"Palliat Med"},{"issue":"2","key":"1330_CR37","doi-asserted-by":"publisher","first-page":"146","DOI":"10.4037\/aacnacc2020285","volume":"31","author":"EG Epstein","year":"2020","unstructured":"Epstein EG, Haizlip J, Liaschenko J, Zhao D, Bennett R, Marshall MF. Moral distress, mattering, and secondary traumatic stress in provider burnout: a call for moral community. AACN Adv Crit Care. 2020;31(2):146\u201357.","journal-title":"AACN Adv Crit Care"},{"issue":"4","key":"1330_CR38","doi-asserted-by":"publisher","DOI":"10.20452\/pamw.16484","volume":"133","author":"M Norvell","year":"2023","unstructured":"Norvell M, Connors CA, Wu AW. Helping without harm: providing emotional support to health care workers in 2023. Pol Arch Intern Med. 2023;133(4):16484.","journal-title":"Pol Arch Intern Med"},{"key":"1330_CR39","unstructured":"Weiner J. Expanding Scope of Practice After COVID-19. University of Pennsylvania School of Nursing; 2021. Available from: https:\/\/ldi.upenn.edu\/wp-content\/uploads\/2021\/06\/PennLDI-PennNursing-Expanding-Scope-of-Practice-After-COVID-19-Brief.pdf."},{"issue":"1","key":"1330_CR40","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.outlook.2021.07.012","volume":"70","author":"L Poghosyan","year":"2022","unstructured":"Poghosyan L, Pulcini J, Chan GK, Dunphy L, Martsolf GR, Greco K, et al. State responses to COVID-19: potential benefits of continuing full practice authority for primary care nurse practitioners. Nurs Outlook. 2022;70(1):28\u201335.","journal-title":"Nurs Outlook"},{"issue":"2","key":"1330_CR41","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1177\/104973150101100202","volume":"11","author":"A Flexner","year":"2001","unstructured":"Flexner A. Is social work a profession? Res Soc Work Pract. 2001;11(2):152\u201365.","journal-title":"Res Soc Work Pract"},{"issue":"6","key":"1330_CR42","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1177\/0020872820959706","volume":"63","author":"T Kourgiantakis","year":"2020","unstructured":"Kourgiantakis T, Lee E. Social work practice education and training during the pandemic: disruptions and discoveries. Int Soc Work. 2020;63(6):761\u20135.","journal-title":"Int Soc Work"},{"issue":"1","key":"1330_CR43","doi-asserted-by":"publisher","DOI":"10.1186\/s12910-021-00700-9","volume":"22","author":"G Schofield","year":"2021","unstructured":"Schofield G, Dittborn M, Selman LE, Huxtable R. Defining ethical challenge(s) in healthcare research: a rapid review. BMC Med Ethics. 2021;22(1):135.","journal-title":"BMC Med Ethics"},{"key":"1330_CR44","unstructured":"Allen K. What is an ethical dilemma. The New Social Worker. 2012 Spring; 19. Available from: https:\/\/www.socialworker.com\/feature-articles\/ethics-articles\/What_Is_an_Ethical_Dilemma%3F\/."}],"container-title":["BMC Medical Ethics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12910-025-01330-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12910-025-01330-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12910-025-01330-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T15:44:05Z","timestamp":1764171845000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedethics.biomedcentral.com\/articles\/10.1186\/s12910-025-01330-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,26]]},"references-count":44,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["1330"],"URL":"https:\/\/doi.org\/10.1186\/s12910-025-01330-1","relation":{},"ISSN":["1472-6939"],"issn-type":[{"value":"1472-6939","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,26]]},"assertion":[{"value":"6 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Approval to conduct this study was obtained by the Institutional Review Board of the University of Georgia (IRB study #00002248). Verbal informed consent was obtained from all participants of this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"No data in this manuscript can be used to identify any of our participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"166"}}