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  1. Exploring views of South African research ethics committees on pandemic preparedness and response during COVID-19.Theresa Burgess, Stuart Rennie & Keymanthri Moodley - 2024 - Research Ethics 20 (4):701-730.
    South African research ethics committees (RECs) faced significant challenges during the COVID-19 pandemic. Research ethics committees needed to find a balance between careful consideration of scientific validity and ethical merit of protocols, and review with the urgency normally associated with public health emergency research. We aimed to explore the views of South African RECs on their pandemic preparedness and response during COVID-19. We conducted in-depth interviews with 21 participants from RECs that were actively involved in the review of COVID-19 related (...)
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  • Physiotherapists’ moral distress: Mixed-method study reveals new insights.Noit Inbar, Israel Issi Doron & Yocheved Laufer - 2024 - Nursing Ethics 31 (8):1537-1550.
    Background Moral distress is a well-recognized term for emotional, cognitive, and physical reactions of professionals, when facing conflicts between perceived obligations and institutional constraints. Though studied across medical roles, limited research exists among physiotherapists. Research Question What factors contribute to Moral distress among physiotherapists and how do they cope? Objectives To develop and test a multifaceted model of Moral distress and gain an in-depth understanding of the phenomena. Research Design A 2017–2022 mixed-methods study: (1) Survey of 407 physiotherapists quantitatively testing (...)
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  • Clinician Moral Distress: Toward an Ethics of Agent‐Regret.Daniel T. Kim, Wayne Shelton & Megan K. Applewhite - 2023 - Hastings Center Report 53 (6):40-53.
    Moral distress names a widely discussed and concerning clinician experience. Yet the precise nature of the distress and the appropriate practical response to it remain unclear. Clinicians speak of their moral distress in terms of guilt, regret, anger, or other distressing emotions, and they often invoke them interchangeably. But these emotions are distinct, and they are not all equally fitting in the same circumstances. This indicates a problematic ambiguity in the moral distress concept that obscures its distinctiveness, its relevant circumstances, (...)
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  • Moral distress among nurse leaders: A qualitative systematic review.Preston H. Miller, Elizabeth G. Epstein, Todd B. Smith, Teresa D. Welch, Miranda Smith & Jennifer R. Bail - 2023 - Nursing Ethics 30 (7-8):939-959.
    Moral distress (MD) is well-documented within the nursing literature and occurs when constraints prevent a correct course of action from being implemented. The measured frequency of MD has increased among nurses over recent years, especially since the COVID-19 Pandemic. MD is less understood among nurse leaders than other populations of nurses. A qualitative systematic review was conducted with the aim to synthesize the experiences of MD among nurse leaders. This review involved a search of three databases (Medline, CINAHL, and APA (...)
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  • Moral Stress and Moral Distress: Confronting Challenges in Healthcare Systems under Pressure.Mara Buchbinder, Alyssa Browne, Nancy Berlinger, Tania Jenkins & Liza Buchbinder - 2023 - American Journal of Bioethics 24 (12):8-22.
    Stresses on healthcare systems and moral distress among clinicians are urgent, intertwined bioethical problems in contemporary healthcare. Yet conceptualizations of moral distress in bioethical inquiry often overlook a range of routine threats to professional integrity in healthcare work. Using examples from our research on frontline physicians working during the COVID-19 pandemic, this article clarifies conceptual distinctions between moral distress, moral injury, and moral stress and illustrates how these concepts operate together in healthcare work. Drawing from the philosophy of healthcare, we (...)
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  • Moral distress in acute psychiatric nursing: Multifaceted dilemmas and demands.Trine-Lise Jansen, Marit Helene Hem, Lars Johan Dambolt & Ingrid Hanssen - 2020 - Nursing Ethics 27 (5):1315-1326.
    Background In this article, the sources and features of moral distress as experienced by acute psychiatric care nurses are explored. Research design A qualitative design with 16 individual in-depth interviews was chosen. Braun and Clarke’s six analytic phases were used. Ethical considerations Approval was obtained from the Norwegian Social Science Data Services. Participation was confidential and voluntary. Findings Based on findings, a somewhat wider definition of moral distress is introduced where nurses experiencing being morally constrained, facing moral dilemmas or moral (...)
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  • What is ‘moral distress’ in nursing? A feminist empirical bioethics study.Georgina Morley, Caroline Bradbury-Jones & Jonathan Ives - 2020 - Nursing Ethics 27 (5):1297-1314.
    Background The phenomenon of ‘moral distress’ has continued to be a popular topic for nursing research. However, much of the scholarship has lacked conceptual clarity, and there is debate about what it means to experience moral distress. Moral distress remains an obscure concept to many clinical nurses, especially those outside of North America, and there is a lack of empirical research regarding its impact on nurses in the United Kingdom and its relevance to clinical practice. Research aim To explore the (...)
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  • Moral distress in nurses: Resources and constraints, consequences, and interventions.Mohammad Javad Ghazanfari, Amir Emami Zeydi, Reza Panahi, Reza Ghanbari, Fateme Jafaraghaee, Hamed Mortazavi & Samad Karkhah - 2022 - Clinical Ethics 17 (3):265-271.
    Background Moral distress is a complex and challenging issue in the nursing profession that can negatively affect the nurses’ job satisfaction and retention and the quality of patient care. This study focused on describing the resources and constraints, consequences, and interventions of moral distress in nurses. Methods In a literature review, an extensive electronic search was conducted in databases including PubMed, ISI, Scopus as well as Google Scholar search engine using the keywords including “moral distress” and “nurses” to identify resources, (...)
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  • Moral distress interventions: An integrative literature review.Vanessa K. Amos & Elizabeth Epstein - 2022 - Nursing Ethics 29 (3):582-607.
    Moral distress has been well reviewed in the literature with established deleterious side effects for all healthcare professionals, including nurses, physicians, and others. Yet, little is known about the quality and effectiveness of interventions directed to address moral distress. The aim of this integrative review is to analyze published intervention studies to determine their efficacy and applicability across hospital settings. Of the initial 1373 articles discovered in October 2020, 18 were appraised as relevant, with 1 study added by hand search (...)
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  • Clinician distress in seriously ill patient care: A dimensional analysis.Anessa M. Foxwell, Salimah H. Meghani & Connie M. Ulrich - 2022 - Nursing Ethics 29 (1):72-93.
    Background: Caring for patients with serious illness may severely strain clinicians causing distress and probable poor patient outcomes. Unfortunately, clinician distress and its impact historically has received little attention. Research purpose: The purpose of this article was to investigate the nature of clinician distress. Research design: Qualitative inductive dimensional analysis. Participants and research context: After review of 577 articles from health sciences databases, a total of 33 articles were eligible for analysis. Ethical considerations: This study did not require ethical review (...)
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  • Defining ethical challenge(s) in healthcare research: a rapid review.Richard Huxtable, Lucy Ellen Selman, Mariana Dittborn & Guy Schofield - 2021 - BMC Medical Ethics 22 (1):1-17.
    BackgroundDespite its ubiquity in academic research, the phrase ‘ethical challenge(s)’ appears to lack an agreed definition. A lack of a definition risks introducing confusion or avoidable bias. Conceptual clarity is a key component of research, both theoretical and empirical. Using a rapid review methodology, we sought to review definitions of ‘ethical challenge(s)’ and closely related terms as used in current healthcare research literature.MethodsRapid review to identify peer-reviewed reports examining ‘ethical challenge(s)’ in any context, extracting data on definitions of ‘ethical challenge(s)’ (...)
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  • How do healthcare professionals respond to ethical challenges regarding information management? A review of empirical studies.Cornelius Ewuoso, Susan Hall & Kris Dierickx - 2021 - Global Bioethics 32 (1):67-84.
    Aim This study is a systematic review that aims to assess how healthcare professionals manage ethical challenges regarding information within the clinical context.Method and Materials We carried out searches in PubMed, Google Scholar and Embase, using two search strings; searches generated 665 hits. After screening, 47 articles relevant to the study aim were selected for review. Seven articles were identified through snowballing, and 18 others were included following a system update in PubMed, bringing the total number of articles reviewed to (...)
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  • Enhancing Understanding of Moral Distress: The Measure of Moral Distress for Health Care Professionals.Elizabeth G. Epstein, Phyllis B. Whitehead, Chuleeporn Prompahakul, Leroy R. Thacker & Ann B. Hamric - 2019 - AJOB Empirical Bioethics 10 (2):113-124.
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  • Moral distress of undergraduate nursing students in community health nursing.Rowena L. Escolar Chua & Jaclyn Charmaine J. Magpantay - 2019 - Nursing Ethics 26 (7-8):2340-2350.
    Background: Nurses exposed to community health nursing commonly encounter situations that can be morally distressing. However, most research on moral distress has focused on acute care settings and very little research has explored moral distress in a community health nursing setting especially among nursing students. Aim: To explore the moral distress experiences encountered by undergraduate baccalaureate nursing students in community health nursing. Research design: A descriptive qualitative design was employed to explore the community health nursing experiences of the nursing students (...)
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  • What's Philosophical About Moral Distress?Nancy J. Matchett - 2018 - Philosophical Practice: Journal of the American Philosophical Practitioners Association 2 (13):2108-19.
    Moral distress is a well-documented phenomenon in the nursing profession, and increasingly thought to be implicated in a nation-wide nursing shortage in the US. First identified by the philosopher Andrew Jameton in 1984, moral distress has also proven resistant to various attempts to prevent its occurrence or at least mitigate its effects. While this would seem to be bad news for nurses and their patients, it is potentially good news for philosophical counselors, for whom there is both socially important and (...)
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  • Moral sensitivity, moral distress, and moral courage among baccalaureate Filipino nursing students.Rowena L. Escolar-Chua - 2018 - Nursing Ethics 25 (4):458-469.
    Background:Moral distress, moral sensitivity, and moral courage among healthcare professionals have been explored considerably in recent years. However, there is a paucity of studies exploring these topics among baccalaureate nursing students.Aim/objective:The purpose of this study was to explore the relationship between and among moral distress, moral sensitivity, and moral courage of undergraduate baccalaureate nursing students.Research design:The research employed a descriptive-correlational design to explore the relationships between and among moral distress, moral sensitivity, and moral courage of undergraduate nursing students.Participants and research (...)
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  • Psychometric evaluation of the Moral Distress Scale–Revised among Iranian Nurses.Mohammad Ali Soleimani, Saeed Pahlevan Sharif, Ameneh Yaghoobzadeh & Bianca Panarello - 2019 - Nursing Ethics 26 (4):1226-1242.
    Background: Experiencing moral distress is traumatic for nurses. Ignoring moral distress can lead to job dissatisfaction, improper handling in the care of patients, or even leaving the job. Thus, it is crucial to use valid and reliable instruments to measure moral distress. Objective: The purpose of this study was to determine the reliability and the validity of the Persian version of the Moral Distress Scale–Revised among a sample of Iranian nurses. Research design: In this methodological study, 310 nurses were recruited (...)
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  • What is ‘moral distress’? A narrative synthesis of the literature.Georgina Morley, Jonathan Ives, Caroline Bradbury-Jones & Fiona Irvine - 2019 - Nursing Ethics 26 (3):646-662.
    Aims: The aim of this narrative synthesis was to explore the necessary and sufficient conditions required to define moral distress. Background: Moral distress is said to occur when one has made a moral judgement but is unable to act upon it. However, problems with this narrow conception have led to multiple redefinitions in the empirical and conceptual literature. As a consequence, much of the research exploring moral distress has lacked conceptual clarity, complicating attempts to study the phenomenon. Design: Systematic literature (...)
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  • Shared Language and Moral Sensibility in Resolving Clinical Ethics Conflicts.Anand Muthusamy - 2015 - American Journal of Bioethics 15 (1):60-61.
    Autumn Fiester's “Neglected Ends: Clinical Ethics Consultation and the Prospects for Closure” (2015) demonstrates how a focus on recommendations in clinical ethics consultations (CECs) can fail to...
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  • Perceptions of moral integrity: Contradictions in need of explanation.Carolyn Laabs - 2011 - Nursing Ethics 18 (3):431-440.
    The incidence of moral distress, compromised moral integrity, and leaving nursing is highest among nurses new to the profession. Understanding perceptions of moral integrity may assist in developing strategies to reduce distress and promote workforce retention. The purpose of this study was to determine how newly graduated baccalaureate prepared nurses perceive moral integrity and how prepared they feel to manage challenges to it. The design was qualitative descriptive using a confidential short answer online survey. Data were analyzed using conventional content (...)
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  • Empirical Research on Moral Distress: Issues, Challenges, and Opportunities. [REVIEW]Ann B. Hamric - 2012 - HEC Forum 24 (1):39-49.
    Abstract Studying a concept as complex as moral distress is an ongoing challenge for those engaged in empirical ethics research. Qualitative studies of nurses have illuminated the experience of moral distress and widened the contours of the concept, particularly in the area of root causes. This work has led to the current understanding that moral distress can arise from clinical situations, factors internal to the individual professional, and factors present in unit cultures, the institution, and the larger health care environment. (...)
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  • Framing the Issues: Moral Distress in Health Care. [REVIEW]Bernadette M. Pauly, Colleen Varcoe & Jan Storch - 2012 - HEC Forum 24 (1):1-11.
    Moral distress in health care has been identified as a growing concern and a focus of research in nursing and health care for almost three decades. Researchers and theorists have argued that moral distress has both short and long-term consequences. Moral distress has implications for satisfaction, recruitment and retention of health care providers and implications for the delivery of safe and competent quality patient care. In over a decade of research on ethical practice, registered nurses and other health care practitioners (...)
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  • Caring ethics and a Somali reproductive dilemma.Robin Narruhn & Ingra R. Schellenberg - 2013 - Nursing Ethics 20 (4):366-381.
    The use of traditional ethical methodologies is inadequate in addressing a constructed maternal–fetal rights conflict in a multicultural obstetrical setting. The use of caring ethics and a relational approach is better suited to address multicultural conceptualizations of autonomy and moral distress. The way power differentials, authoritative knowledge, and informed consent are intertwined in this dilemma will be illuminated by contrasting traditional bioethics and a caring ethics approach. Cultural safety is suggested as a way to develop a relational ontology. Using caring (...)
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  • Values and self-perception of behaviour among critical care nurses.Kaoru Ashida, Aki Kawakami, Tetsuharu Kawashima & Makoto Tanaka - 2021 - Nursing Ethics 28 (7-8):1348-1358.
    Background: Moral distress has various adverse effects on nurses working in critical care. Differences in personal values, and between values and self-perception of behaviour are factors that may cause moral distress. Research aims: The aims of this study were (1) to identify ethical values and self-perception of behaviour of critical care nurses in Japan and (2) to determine the items with a large difference between value and behaviour and the items with a large difference in value from others. Research design: (...)
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  • Re-defining moral distress: A systematic review and critical re-appraisal of the argument-based bioethics literature.Christine Sanderson, Linda Sheahan, Slavica Kochovska, Tim Luckett, Deborah Parker, Phyllis Butow & Meera Agar - 2019 - Clinical Ethics 14 (4):195-210.
    The concept of moral distress comes from nursing ethics, and was initially defined as ‘…when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action’. There is a large body of literature associated with moral distress, yet multiple definitions now exist, significantly limiting its usefulness. We undertook a systematic review of the argument-based bioethics literature on this topic as the basis for a critical appraisal, identifying 55 papers for analysis. (...)
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  • Ethicist as Healer: Is Offering Justified Normative Recommendations All We Are Doing in Active Patient Cases?Jeffrey S. Farroni - 2019 - American Journal of Bioethics 19 (11):85-87.
    Volume 19, Issue 11, November 2019, Page 85-87.
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  • Should Human Rights and Autonomy be The Primary Determinants for the Disclosure of a Decision to Withhold Futile Resuscitation?Sarah Cahill - 2019 - The New Bioethics 25 (1):39-59.
    Do not attempt cardiopulmonary resuscitation decisions (DNACPR) are considered good medical practice for those dying at the end of natural life. They avoid intrusive and inappropriate intervention. Historically, informing patients of these decisions was discretionary to avoid undue distress. Recent legal rulings have altered clinical guidance: disclosure is now all but obligatory. The basis for these legal judgments was respect for the patient’s autonomy as an expression of their human rights. Through critical analysis, this paper explores other bioethical considerations and (...)
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  • The Pitfalls of Proceduralism: An Exploration of the Goods Internal to the Practice of Clinical Ethics Consultation.Annie B. Friedrich - 2018 - HEC Forum 30 (4):389-403.
    In an age of professionalization and specialization, the practice of clinical ethics is facing an identity crisis. Are clinical ethicists moral experts, ethics experts, or merely quasi-lawyers giving legal advice? Are they extensions of the hospital, always working to advance the hospital’s interests? Or is there another option? Since 1998, when the American Society for Bioethics and Humanities first issued its Core Competencies for Healthcare Ethics Consultation, there has been debate about the role of standardization and proceduralism in clinical ethics (...)
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  • The Standard Account of Moral Distress and Why We Should Keep It.Joan McCarthy & Settimio Monteverde - 2018 - HEC Forum 30 (4):319-328.
    In the last three decades, considerable theoretical and empirical research has been undertaken on the topic of moral distress among health professionals. Understood as a psychological and emotional response to the experience of moral wrongdoing, there is evidence to suggest that—if unaddressed—it contributes to staff demoralization, desensitization and burnout and, ultimately, to lower standards of patient safety and quality of care. However, more recently, the concept of moral distress has been subjected to important criticisms. Specifically, some authors argue that the (...)
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  • From “Longshot” to “Fantasy”: Obligations to Pediatric Patients and Families When Last-Ditch Medical Efforts Fail.Elliott Mark Weiss & Autumn Fiester - 2018 - American Journal of Bioethics 18 (1):3-11.
    Clinicians at quaternary centers see part of their mission as providing hope when others cannot. They tend to see sicker patients with more complex disease processes. Part of this mission is offering longshot treatment modalities that are unlikely to achieve their stated goal, but conceivably could. When patients embark on such a treatment plan, it may fail. Often treatment toward an initial goal continues beyond the point at which such a goal is feasible. We explore the progression of care from (...)
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  • A Philosophical Taxonomy of Ethically Significant Moral Distress: Figure 1.Tessy A. Thomas & Laurence B. McCullough - 2015 - Journal of Medicine and Philosophy 40 (1):102-120.
    Moral distress is one of the core topics of clinical ethics. Although there is a large and growing empirical literature on the psychological aspects of moral distress, scholars, and empirical investigators of moral distress have recently called for greater conceptual clarity. To meet this recognized need, we provide a philosophical taxonomy of the categories of what we call ethically significant moral distress: the judgment that one is not able, to differing degrees, to act on one’s moral knowledge about what one (...)
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  • Hand Hygiene as Standard Practice.Marcia Bosek & Hollie Shaner-McRae - 2010 - Jona's Healthcare Law, Ethics, and Regulation 12 (4):101-105.
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  • 'Moral distress' - time to abandon a flawed nursing construct?Megan-Jane Johnstone & Alison Hutchinson - 2015 - Nursing Ethics 22 (1):5-14.
    Moral distress has been characterised in the nursing literature as a major problem affecting nurses in all healthcare systems. It has been portrayed as threatening the integrity of nurses and ultimately the quality of patient care. However, nursing discourse on moral distress is not without controversy. The notion itself is conceptually flawed and suffers from both theoretical and practical difficulties. Nursing research investigating moral distress is also problematic on account of being methodologically weak and disparate. Moreover, the ultimate purpose and (...)
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  • Moral Distress: Tensions as Springboards for Action. [REVIEW]Colleen Varcoe, Bernadette Pauly, George Webster & Janet Storch - 2012 - HEC Forum 24 (1):51-62.
    In the previous four papers in this series, individual versus structural or contextual factors have informed various understandings of moral distress. In this final paper, we summarize some of the key tensions raised in previous papers and use these tensions as springboards to identify directions for action among practitioners, educators, researchers, policymakers and others. In particular, we recognize the need to more explicitly politicize the concept of moral distress in order to understand how such distress arises from competing values within (...)
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  • ‘Sit down and thrash it out’: opportunities for expanding ethics consultation during conflict resolution in long-term care.David N. Hoffman & Gianna R. Strand - 2024 - The New Bioethics 30 (2):152-162.
    Objective: To identify the frequency and nature of care conflict dilemmas that United States long-term care providers encounter, response strategies, and use of ethics resources to assist with dispute resolution. Design: An online cross-sectional survey was distributed to the Society for Post-Acute and Long-Term Care Medicine (AMDA). Results: Two-thirds of participants, primarily medical directors, have rejected surrogate instructions and 71% have managed family conflict. Conflict over treatment decisions and issues interpreting advance directives were frequently reported. Half of facilities lack a (...)
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  • Psychiatric nurses’ experience of moral distress: Its relationship with empowerment and coping.Michiko Tomura - 2023 - Nursing Ethics 30 (7-8):1095-1113.
    Background Research has shown that moral distress negatively impacts nurses, patients, and organizations; however, several scholars have argued that it can be an opportunity for positive outcomes. Thus, factors that may mitigate moral distress and catalyze positive change need to be explored. Research aim The purpose of this study was to explore the relationships among structural and psychological empowerment, psychiatric staff nurses’ experience of moral distress, and strategies for coping with moral distress. Research design A descriptive cross-sectional correlational study. Participants (...)
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  • Moral residue and health justice for the global south: Addressing past issues through current interventions and research.Samuel J. Ujewe - 2019 - Developing World Bioethics 20 (2):96-104.
    This paper introduces the concept of moral residue to global health, and shows how its presence undermines crucial interventions and research, especially in the global south. Lingering feelings of anxiety, anger, blame or frustration often exist among local populations, where previous interventions or research have left traces of harm and/or exploitation. The existence of such feelings reflects the presence of moral residue, recognizing the moral experiences of epistemic injustices, which in turn undermines critical interventions and research through outright rejection or (...)
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  • Moral distress in medical student reflective writing.Mary Camp & John Sadler - 2019 - AJOB Empirical Bioethics 10 (1):70-78.
    Purpose: Moral distress occurs when one identifies an ethically appropriate course of action but cannot carry it out. In this conceptualization, medical students may be particularly vulnerable to m...
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  • Care, Commitment and Moral Distress.Joseph P. Walsh - 2018 - Ethical Theory and Moral Practice 21 (3):615-628.
    Moral distress has been the subject of extensive research and debate in the nursing ethics literature since the mid-1980s, but the concept has received comparatively little attention from those working outside of applied ethics. In this article, I defend a care ethical account of moral distress, according to which the phenomenon is the product of an agent’s inability to live up to one of her caring commitments. This account has a number of attractions. First, it places a greater emphasis on (...)
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  • A Broader Understanding of Moral Distress.Stephen M. Campbell, Connie M. Ulrich & Christine Grady - 2016 - American Journal of Bioethics 16 (12):2-9.
    On the traditional view, moral distress arises only in cases where an individual believes she knows the morally right thing to do but fails to perform that action due to various constraints. We seek to motivate a broader understanding of moral distress. We begin by presenting six types of distress that fall outside the bounds of the traditional definition and explaining why they should be recognized as forms of moral distress. We then propose and defend a new and more expansive (...)
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  • Realistic Goals and Expectations for Clinical Ethics Consultations: We Should Not Overstate What We Can Deliver.Wayne N. Shelton & Bruce D. White - 2015 - American Journal of Bioethics 15 (1):54-56.
    The article by Professor Fiester (2015) expresses concern about the long-term moral distress or negative moral emotions, both aspects of moral residue, that linger in some stakeholders’ experiences...
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  • Making the Call: A Proactive Ethics Framework. [REVIEW]Carol Pavlish, Katherine Brown-Saltzman, Alyssa Fine & Patricia Jakel - 2013 - HEC Forum 25 (3):269-283.
    This manuscript proposes a proactive framework for preventing or mitigating disruptive ethical conflicts that often result from delayed or avoided conversations about the ethics of care. Four components of the framework are explained and illustrated with evidenced-based actions. Clinical implications of adopting a prevention-based, system-wide ethics framework are discussed. While some aspects of ethically-difficult situations are unique, system patterns allow some issues to occur repeatedly—often with lingering effects such as healthcare providers’ disengagement and moral distress (McAndrew et al. Journal of (...)
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  • Exploring moral distress in potential sibling stem cell donors.Ann Begley & Susan Piggott - 2013 - Nursing Ethics 20 (2):178-188.
    In relation to the phenomenon of moral distress, this article presents two original perspectives. First, the literature to date reflects a focus on moral distress in an occupational context. In this article, however, the impact of moral distress on siblings is explored. Moral distress is considered in a particular context, stem cell donation, but there are clear insights and implications for wider practice, particularly in life-threatening contexts and situations where live donation enhances the potential for survival. Second, the article represents (...)
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  • E-walks bring ethics to the bedside: A nurse ethicist’s reflections.Brenda Barnum - 2023 - Nursing Ethics 30 (5):720-729.
    The unique role of the nurse ethicist in the clinical setting is one meant to enhance the ethical capacity of nurses, and front-line healthcare providers. As a nurse ethicist, it is also my goal to enhance the ethical climate of each individual work area, patient care unit, and the broader institution by encouraging ethical conversations, navigating ethical dilemmas, and seeking creative solutions to minimize moral distress and burnout. To provide preventive ethics support and education, I began regularly visiting patient care (...)
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  • Moral distress among critical care nurses: A cross-cultural comparison.Kaoru Ashida, Tetsuharu Kawashima, Aki Kawakami & Makoto Tanaka - 2022 - Nursing Ethics 29 (6):1341-1352.
    Background Although, moral distress presents a serious problem among critical care nurses in many countries, limited research has been conducted on it. A validated scale has been developed to evaluate moral distress and has enabled cross-cultural comparison for seeking its root causes. Research aims This study aimed to (1) clarify the current status of moral distress among nurses who worked in critical care areas in Japan, (2) compare the moral distress levels among nurses in Japan with previously reported results from (...)
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  • PASTRY: A nursing-developed quality improvement initiative to combat moral distress.Emily Long Sarro, Kelly Haviland, Kimberly Chow, Sonia Sequeira, Mary Eliza McEachen, Kerry King, Lauren Aho, Nessa Coyle, Hao Zhang, Kathleen A. Lynch, Louis Voigt & Mary S. McCabe - 2022 - Nursing Ethics 29 (4):1066-1077.
    Background High levels of moral distress in nursing professionals, of which oncology nurses are particularly prone, can negatively impact patient care, job satisfaction, and retention. Aim “Positive Attitudes Striving to Rejuvenate You: PASTRY” was developed at a tertiary cancer center to reduce the burden of moral distress among oncology nurses. Research Design A Quality Improvement (QI) initiative was conducted using a pre- and post-intervention design, to launch PASTRY and measure its impact on moral distress of the nursing unit, using Hamric’s (...)
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  • Reflecting Before, During, and After the Heat of the Moment: A Review of Four Approaches for Supporting Health Staff to Manage Stressful Events. [REVIEW]C. Delany, S. Jones, J. Sokol, L. Gillam & T. Prentice - 2021 - Journal of Bioethical Inquiry 18 (4):573-587.
    Being a healthcare professional in both paediatric and adult hospitals will mean being exposed to human tragedies and stressful events involving conflict, misunderstanding, and moral distress. There are a number of different structured approaches to reflection and discussion designed to support healthcare professionals process and make sense of their feelings and experiences and to mitigate against direct and vicarious trauma. In this paper, we draw from our experience in a large children’s hospital and more broadly from the literature to identify (...)
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  • Moral injury in healthcare professionals: A scoping review and discussion.Anto Čartolovni, Minna Stolt, P. Anne Scott & Riitta Suhonen - 2021 - Nursing Ethics 28 (5):590-602.
    Moral injury emerged in the healthcare discussion quite recently because of the difficulties and challenges healthcare workers and healthcare systems face in the context of the COVID-19 pandemic. Moral injury involves a deep emotional wound and is unique to those who bear witness to intense human suffering and cruelty. This article aims to synthesise the very limited evidence from empirical studies on moral injury and to discuss a better understanding of the concept of moral injury, its importance in the healthcare (...)
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  • Moral distress in health care: when is it fitting?Lisa Tessman - 2020 - Medicine, Health Care and Philosophy 23 (2):165-177.
    Nurses and other medical practitioners often experience moral distress: they feel an anguished sense of responsibility for what they take to be their own moral failures, even when those failures were unavoidable. However, in such cases other people do not tend to think it is right to hold them responsible. This is an interesting mismatch of reactions. It might seem that the mismatch should be remedied by assuring the practitioner that they are not responsible, but I argue that this denies (...)
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  • Clinical Ethics as a Profession?Sabine Salloch - 2019 - American Journal of Bioethics 19 (11):87-89.
    Volume 19, Issue 11, November 2019, Page 87-89.
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