Physician Wellness/BurnoutA Call to Restore Your Calling Self-Care of the Emergency Physician in the Face of Life-Changing Stress—Part 4 of 6: Physician Helplessness and Moral InjuryMiller, Elissa G. MD∗; Mull, Colette C. MD†Editor(s): Mull, Colette C. MD, Editor Author Information From the ∗Division of Palliative Medicine †Division of Emergency Medicine, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Sidney Kimmel Medical College, Thomas Jefferson University, Wilmington, DE. Disclosure: The authors declare no conflict of interest. Reprints: Colette C. Mull, MD, Division of Emergency Medicine, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Rd, Wilmington, DE 19803 (e-mail: [email protected]). Pediatric Emergency Care: November 2019 - Volume 35 - Issue 11 - p 811-813 doi: 10.1097/PEC.0000000000001972 Buy Metrics Abstract Many aspects of our health care system in the United States can lead to physicians feeling helpless—an inability to save a dying child, an inability to protect an immunocompromised child from a vaccine-preventable illness because of waning herd immunity, and a burdensome new electronic medical record system that your employer insists you must use. The cumulative effect of these experiences can lead to moral distress and ultimately moral injury. We discuss helplessness, moral distress, and moral injury in the setting of today's practice of emergency medicine and provide concrete recommendations to help providers cope with their own reactions to distressing clinical situations. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.