Table 2.

Categories of HCP reported moral distress

Category of moral distress	Description	Frequency (n)	%
Patient relapse or death	Distress related to witnessing relapse or death among enrolled children	8	38.1%
Emotional bonds with families	Distress linked to close emotional relationships with patients/families	6	28.6%
Balancing research with patient well-being	Ethical unease regarding trial participation decisions	5	23.8%
Parental and family distress	Emotional strain related to witnessing patients or parental suffering	3	14.3%
Research-related demands during decline	Stress associated with research procedures or trial requirements during period of clinical deterioration	3	14.3%

Categories of moral distress reported by HCPs (n = 21 valid respondents; multiple responses allowed). Percentages sum to more than 100% because respondents could report more than one category