Table 2.

Persons or entities that clinician’s comments identified as responsible for the issues they found most morally distressing (n=508 comments)

Responsible person or entity	Representative comments
The clinician–respondent (n=159; 31% of all responsible parties)	Not being able to provide care of the same quality as pre-pandemic; having to cancel on clients to take care of myself; Being unable to treat patients in need because my clinic closed
The clinician’s clinic or organisation (n=74; 15% of all responsible parties)	My clinic wasn't telling staff or clients when there were positive covid cases in the building and i was told not to as well; The conflict between organization pushing for in person visit when often telemedicine would be more appropriate
Government/politicians/society (n=69; 14% of all responsible parties)	Poor handling of covid at federal and state levels; the failure of presidential leadership; racism, hatred, lack of moral responsibility shown by others
Patients (n=16; 3% of all responsible parties)	Patients coming into the consult room and taking off their mask; patients dishonesty during screening process
The public (n=14; 3% of all responsible parties)	Lack of social responsibility of others to wear a mask; Anti-maskers/Conspiracy Theorists/ Anti-vaxxers
Clinic staff and/or administrator (n=13; 3% of all responsible parties)	Providers/staff not following covid protocols; a decline in the medical staff treatment of some of the pts; My MA declining covid testing… while family at home had covid.
Unspecified/unclear/other (n=163; 32% of all responsible parties)	My clients anxiety; Needless deaths; Potential to exposure; Forced lock downs. covid screening and testing