Background: Futile care of patients with less than five percent chance of survival places nurses in moral distress conditions. The aim of this study was to determine the relationship between perception of futile care and moral distress in nurses in critical care units. Methods: This descriptive-analytic study was performed on 155 nurses in educational hospitals affiliated to Ilam University of Medical Sciences in 2018. Data gathering tools were moral distress (MDS-R) and perception of futile care questionnaires. Data were analyzed by linear regression, Pearson’s correlation coefficient, one way ANOVA and independent t-test by SPSS23 software and p=0.05. Results: In majority of the nurses, the levels of Perception of futile care was high (77.8%) and moral distress was moderate (0.54%). Pearson’s correlation coefficient showed a significant relationship between moral distress and perception of frequency of futile care (r =0.407, p<0.01) as well as perception of intensity of futile care (r =0.381, p<0.01). Increasing perception of futile care increased moral distress in the nurses (p< 0.05). Linear regression indicated a significant relationship between moral distress and perception of frequency of futile care (ẞ =0.263, p=0.034) as well as past clinical experience in critical care units (ẞ =0.209, p=0.023). Conclusion: Levels of perception of futile care was high and moral distress was moderate in the nurses. There was direct and significant relationship between moral distress and perception of futile care. Educating professional ethics and taking palliative care can drive nursing from futile to effective care.
