Addressing Oncologist Burnout, Emotional Well-Being, and Moral Distress in the Pandemic

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JCO Oncology Practice recently published an editorial that examines the intensified burnout oncology practitioners are experiencing due the COVID-19 pandemic and outlines critical interventions to support oncologists now and throughout a long-term recovery.1 The article was written by past, current, and select members of ASCO’s Ethics Committee and Clinician Well-Being Task Force.

The Ethics Committee previously published recommendations addressing burnout and moral distress in oncology prior to the pandemic,2 but with new constraints and pressures, the committee reexamined what can be done specifically to address COVID-19–related burnout.

Understanding Moral Distress

The editorial authors assert that the COVID-19 public health emergency has exacerbated existing oncologist burnout and distress. Oncologists are facing numerous practice changes, intensified burnout, heightened moral distress, and personal challenges (such as family stressors) produced by the pandemic.

The editorial explains how moral distress arises as a direct consequence of both ethical dilemmas and failure to practice according to one’s value and occupational commitment, largely because of perceived lack of professional support and/or organizational constraints. Moral distress is caused by collective experiences of repeated events rather than one individual scenario. Some distress examples related to COVID-19 are lack of personal protective equipment; staff and colleagues on sick leave; and duty to patients vs infectious risk to self, colleagues, and family.

Moral distress can cause clinicians to have negative thoughts about themselves, others, the workplace, and could also lead oncologists to leave the profession if they feel powerless and not well supported.

Pandemic-Specific Methods of Intervention

To ensure the well-being of oncology practitioners, the authors urge individuals in leadership roles at cancer centers and oncology practices to collaborate with their physician workforce to improve the practice environment and culture during COVID-19 and beyond. The editorial provides several evidence-based methods of intervention from current and past epidemics for organizations to implement, including:

  • Conduct a formal assessment of ethical work climate and moral distress
  • Show respect for oncologist values
  • Provide COVID-19 oncology team education
  • Foster community and peer support
  • Establish trauma-informed supportive oncology collaboration.

ASCO aims to support these methods of intervention through programs and collaborative opportunities. Find more resources related to burnout and promoting well-being on ASCO Practice Central and by reading the full editorial in JCO Oncology Practice.1 Learn more about how ASCO plans to address these issues in the ASCO-hosted Webinar on Clinician Well-Being and Burnout,3 and additional burnout intervention methods can be found in the recently published Journal of Clinical Oncology article, “American Society of Clinical Oncology Road to Recovery Report: Learning From the COVID-19 Experience to Improve Clinical Research and Cancer Care.” 4


1. Hlubocky FJ, Symington BE, McFarland DC, et al: Impact of the COVID pandemic on oncologist burnout, emotional well-being, and moral distress: Considerations for the cancer organization’s response for readiness, mitigation, and resilience. JCO Oncol Pract. February 8, 2021 (early release online).

2. Hlubocky FJ, Taylor LP, Marron JM, et al: A call to action: Ethics committee roundtable recommendations for addressing burnout and moral distress in oncology. JCO Oncol Pract 16:191-199, 2020.

3. Hlubocky F, Srivastava P, Back A, et al: Oncology clinician well-being roadmap. Oncology Clinician Well-Being Taskforce. January 26, 2021. Available at Accessed February 19, 2021.

4. Pennell NA, Dillmon M, Levit LA, et al: American Society of Clinical Oncology Road to Recovery Report: Learning from the COVID-19 experience to improve clinical research and cancer care. J Clin Oncol 39:155-169, 2021.

© 2021. American Society of Clinical Oncology. All rights reserved.