{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T06:17:57Z","timestamp":1775110677483,"version":"3.50.1"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Health Serv."],"abstract":"<jats:p>Concerns about clinician fatigue typically focus on burnout and workload, yet less attention has been paid to how the process of making repeated, emotionally and ethically challenging decisions may transiently affect decision quality. The concept of clinical decision fatigue (CDF) remains debated, partly because empirical findings differ across clinical contexts. We propose that CDF is best understood as a short-term, reversible state arising from sustained self-regulatory demands during emotionally and morally salient clinical decision-making. Drawing on contemporary process models of self-regulation, we argue that repeated exposure to empathic strain, moral conflict, and responsibility for consequential outcomes can shift clinicians\u2019 motivational and attentional priorities away from effortful, reflective decision-making toward simplified or defensive strategies. This state is distinct from compassion fatigue and burnout in its timescale, mechanisms, and phenomenology, but may interact with these conditions when episodes recur without recovery. We argue that clinical decision fatigue is a reversible state of regulatory strain that can be situated within a broader continuum of professional exhaustion. Clinical environments that intensify emotional and moral load may accelerate the onset of CDF, whereas structures that support emotion regulation, ethical clarity, and shared decision-making may mitigate it. Recognizing CDF as a modifiable systems risk highlights opportunities to protect decisional integrity, patient safety, and clinician mental health.<\/jats:p>","DOI":"10.3389\/frhs.2026.1810631","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T05:23:47Z","timestamp":1775107427000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical decision fatigue as a reversible state in the continuum of professional exhaustion"],"prefix":"10.3389","volume":"6","author":[{"given":"Serena","family":"Petrocchi","sequence":"first","affiliation":[{"name":"Institute of Family Medicine, Faculty of Biomedical Sciences, Universit\u00e0 Della Svizzera Italiana","place":["Lugano, Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Gabutti","sequence":"additional","affiliation":[{"name":"Cantonal Socio-Psychiatric Organisation, Public Health Division, Department of Health and Social Care, Repubblica e Cantone Ticino","place":["Mendrisio, Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Grignoli","sequence":"additional","affiliation":[{"name":"Institute of Family Medicine, Faculty of Biomedical Sciences, Universit\u00e0 Della Svizzera Italiana","place":["Lugano, Switzerland"]},{"name":"Cantonal Socio-Psychiatric Organisation, Public Health Division, Department of Health and Social Care, Repubblica e Cantone Ticino","place":["Mendrisio, Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1177\/1359105318763510","article-title":"Decision fatigue: a conceptual analysis","volume":"25","author":"Pignatiello","year":"2020","journal-title":"J Health Psychol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e003033","DOI":"10.1136\/fmch-2024-003033","article-title":"Clinical decision fatigue: a systematic and scoping review with meta-synthesis","volume":"13","author":"Grignoli","year":"2025","journal-title":"Fam Med Community Health"},{"key":"B3","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1080\/17437199.2025.2513916","article-title":"Systematic review of the effects of decision fatigue in healthcare professionals on medical decision-making","volume":"19","author":"Maier","year":"2025","journal-title":"Health Psychol Rev"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/S10728-026-00560-7","article-title":"A two-level, multidimensional framework for understanding and treating clinician fatigue","volume":"2026","author":"Buetow","year":"2026","journal-title":"Health Care Anal"},{"key":"B5","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1038\/s44271-025-00207-8","article-title":"No evidence for decision fatigue using large-scale field data from healthcare","volume":"3","author":"Andersson","year":"2025","journal-title":"Communications Psychology"},{"key":"B6","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1111\/J.1467-8721.2007.00534.X","article-title":"The strength model of self-control","volume":"16","author":"Baumeister","year":"2007","journal-title":"Curr Dir Psychol Sci"},{"key":"B7","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1177\/1745691616652873","article-title":"A multilab preregistered replication of the ego-depletion effect","volume":"11","author":"Hagger","year":"2016","journal-title":"Perspect Psychol Sci"},{"key":"B8","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.tics.2013.12.009","article-title":"Why self-control seems (but may not be) limited","volume":"18","author":"Inzlicht","year":"2014","journal-title":"Trends Cogn Sci"},{"key":"B9","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1037\/A0019797","article-title":"Exercising self-control increases approach motivation","volume":"99","author":"Schmeichel","year":"2010","journal-title":"J Pers Soc Psychol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1177\/1745691612454134","article-title":"What is ego depletion? 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