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  1. Moral Distress Among Healthcare Professionals at a Health System.Rose Allen, Tanya Judkins-Cohn, Raul deVelasco, Edwina Forges, Rosemary Lee, Laurel Clark & Maggie Procunier - 2013 - Jona's Healthcare Law, Ethics, and Regulation 15 (3):111-118.
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  • Failing a student nurse.Sharon Black, Joan Curzio & Louise Terry - 2014 - Nursing Ethics 21 (2):224-238.
    The factors preventing registered nurses from failing students in practice are multifaceted and have attracted much debate over recent years. However, writers rarely focus on what is needed to fail an incompetent pre-registration nursing student in their final placement. This hermeneutic study explored the mentor experience of failing a pre-registration nursing student in their final placement. A total of 19 mentors were recruited from 7 different healthcare organisations in both inner city and rural locations in the southeast of England. Participants (...)
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  • Moral distress in nursing: contributing factors, outcomes and interventions.Adam S. Burston & Anthony G. Tuckett - 2013 - Nursing Ethics 20 (3):312-324.
    Moral distress has been widely reviewed across many care contexts and among a range of disciplines. Interest in this area has produced a plethora of studies, commentary and critique. An overview of the literature around moral distress reveals a commonality about factors contributing to moral distress, the attendant outcomes of this distress and a core set of interventions recommended to address these. Interventions at both personal and organizational levels have been proposed. The relevance of this overview resides in the implications (...)
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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 - 2024 - 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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  • Measuring moral distress in health professionals using the MMD-HP-SPA scale.Manuel Romero-Saldaña, Manuel Lopez-Valero, Alejandro Gomez-Carranza, Dolores Aguilera-Lopez, Jaime Boceta-Osuna, Cristina M. Beltran-Aroca & Eloy Girela-Lopez - 2024 - BMC Medical Ethics 25 (1):1-12.
    BackgroundMoral distress (MD) is the psychological damage caused when people are forced to witness or carry out actions which go against their fundamental moral values. The main objective was to evaluate the prevalence and predictive factors associated with MD among health professionals during the pandemic and to determine its causes.MethodsA regional, observational and cross-sectional study in a sample of 566 professionals from the Public Health Service of Andalusia (68.7% female; 66.9% physicians) who completed the MMD-HP-SPA scale to determine the level (...)
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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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  • 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 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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  • 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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  • Understanding moral distress in home-care nursing: An interview study.Julia Petersen, Ulrike Rösler, Gabriele Meyer & Christiane Luderer - 2024 - Nursing Ethics 31 (8):1568-1585.
    Background Moral distress is a far-reaching problem for nurses in different settings as it threatens their health. Aim This study examined which situations lead to moral distress in home-care nursing, how and with which consequences home-care nurses experience moral distress, and how they cope with morally stressful situations and the resulting moral distress. Research design A qualitative interview study with reflexive thematic analysis was used. Participants and research context We conducted semi-structured interviews with 20 home-care nurses in Germany. Ethical considerations (...)
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  • Health care workers’ qualitative descriptions of ethically challenging situations evoking moral distress during Covid-19.Kristin Alve Glad, Hilde Wøien, Synne Øien Stensland, Solveig Klebo Reitan, John Anker Henrik Zwart, Dan Atar, Grete Dyb & Kristina Bondjers - 2024 - Nursing Ethics 31 (8):1709-1721.
    Background The high public demand for healthcare services during the COVID-19 pandemic and strict infection control measures, coupled with threat of severe illness and death, and limited resources, led to many healthcare workers (HCWs) experiencing ethically challenging situations (ECSs). Objective To systematically explore first-hand accounts of ECS-evoking moral distress among HCWs during this public health emergency. Research design This was an open cohort study. All participants were asked whether they had been in ECS-evoking moral distress during the pandemic. Those who (...)
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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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  • 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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  • Moral distress in healthcare assistants: A discussion with recommendations.Daniel Rodger, Bruce Blackshaw & Amanda Young - 2019 - Nursing Ethics 26 (7-8):2306-2313.
    Background: Moral distress can be broadly described as the psychological distress that can develop in response to a morally challenging event. In the context of healthcare, its effects are well documented in the nursing profession, but there is a paucity of research exploring its relevance to healthcare assistants. Objective: This article aims to examine the existing research on moral distress in healthcare assistants, identity the important factors that are likely to contribute to moral distress, and propose preventative measures. Research Design: (...)
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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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  • 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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  • Spiritual well-being and moral distress among Iranian nurses.Mohammad Ali Soleimani, Saeed Pahlevan Sharif, Ameneh Yaghoobzadeh, Mohammad Reza Sheikhi, Bianca Panarello & Ma Thin Mar Win - 2019 - Nursing Ethics 26 (4):1101-1113.
    Background: Moral distress is increasingly recognized as a problem affecting healthcare professionals, especially nurses. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even encourage one to leave the profession. Spiritual well-being is a concept which is considered when dealing with problems and stress relating to a variety of issues. Objective: This research aimed to examine the relationship between spiritual well-being and moral distress among a sample of Iranian nurses and also to (...)
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  • Frontline Healthcare Staffs’ Experience of Organizing Complex Hospital Discharges: An Ethnographic Study.Alexandros Georgiadis, Oonagh Corrigan & Ewen Speed - 2017 - Ethics and Behavior 27 (4):335-350.
    Existing studies show that nurses often experience moral distress when the care they deliver to patients does not meet their professional values. We draw on ethnographic data collected in June 2015 from one acute care trust in England and present how frontline healthcare staff experience organizing complex hospital discharges. Our findings demonstrate how problems with the panel responsible for allocating funding for National Health Service continuing healthcare cases contributed to healthcare staff experiencing moral distress. Our findings offer a basis for (...)
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  • To change or not to change - translating and culturally adapting the paediatric version of the Moral Distress Scale-Revised.Margareta af Sandeberg, Marika Wenemark, Cecilia Bartholdson, Kim Lützén & Pernilla Pergert - 2017 - BMC Medical Ethics 18 (1):14.
    Paediatric cancer care poses ethically difficult situations that can lead to value conflicts about what is best for the child, possibly resulting in moral distress. Research on moral distress is lacking in paediatric cancer care in Sweden and most questionnaires are developed in English. The Moral Distress Scale-Revised is a questionnaire that measures moral distress in specific situations; respondents are asked to indicate both the frequency and the level of disturbance when the situation arises. The aims of this study were (...)
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  • Moral Distress in Scientific Research.David B. Resnik - 2016 - American Journal of Bioethics 16 (12):13-15.
    In their target article “A Broader Understanding of Moral Distress,” Campbell, Ulrich, and Grady (2016) argue that the widely accepted definition of moral distress should be broadened to include so...
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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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  • 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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  • 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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  • Structural Equation Modeling Analysis on Associations of Moral Distress and Dimensions of Organizational Culture in Healthcare: A Cross-Sectional Study of Healthcare Professionals.Tessy A. Thomas, Shelley Kumar, F. Daniel Davis, Peter Boedeker & Satid Thammasitboon - 2024 - AJOB Empirical Bioethics 15 (2):120-132.
    Objective Moral distress is a complex phenomenon experienced by healthcare professionals. This study examined the relationships between key dimensions of Organizational Culture in Healthcare (OCHC)—perceived psychological safety, ethical climate, patient safety—and healthcare professionals’ perception of moral distress.Design Cross-sectional surveySetting Pediatric and adult critical care medicine, and adult hospital medicine healthcare professionals in the United States.Participants Physicians (n = 260), nurses (n = 256), and advanced practice providers (n = 110) participated in the study.Main outcome measures Three dimensions of OCHC were (...)
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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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  • 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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  • The Experience of Moral Distress in an Academic Family Medicine Clinic.Dawn Worsham Bourne & Elizabeth Epstein - 2023 - HEC Forum 35 (1):37-54.
    Background and Objectives Primary care providers (PCPs) report decreased job satisfaction and high levels of burnout, yet little is known about their experience of moral distress. The aim of this study was to gain insight into the experiences of PCPs regarding moral distress including causative factors and proposed mitigation strategies. Methods This qualitative pilot study used semi-structured interviews to identify causes of moral distress in PCPs in an academic family medicine department. Interviews were analyzed using conventional content analysis. Results Of (...)
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  • The effect of professional ethics workshop with virtual follow-up on nurses moral distress.Ali Ghahremani, Fatemeh Esmaelzadeh, Mahboobeh Khosravani & Mohaddeseh Mohsenpour - 2022 - Clinical Ethics 17 (2):191-197.
    Research objectives Moral distress is a common phenomenon among nurses and can negatively affect their mental health and quality of the care. This study aimed to determine the effect of professional ethics workshop with virtual follow-up on the moral distress of nurses. Methods This experimental study was performed on 50 nurses in Ghaem Hospital, Mashhad, Iran. The intervention group received 8-hour professional ethics workshop and 4 weeks follow-up through social network. The moral distress was evaluated through the Moral Distress Scale-Revised (...)
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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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  • (1 other version)Conscientious objection and moral distress: a relational ethics case study of MAiD in Canada.Mary Kathleen Deutscher Heilman & Tracy J. Trothen - 2020 - Journal of Medical Ethics Recent Issues 46 (2):123-127.
    Conscientious objection has become a divisive topic in recent bioethics publications. Discussion has tended to frame the issue in terms of the rights of the healthcare professional versus the rights of the patient. However, a rights-based approach neglects the relational nature of conscience, and the impact that violating one’s conscience has on the care one provides. Using medical assistance in dying as a case study, we suggest that what has been lacking in the discussion of conscientious objection thus far is (...)
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  • Not knowing the “right thing to do:” Moral distress and tolerating uncertainty in medicine.Christinia Landry - 2017 - Clinical Ethics 12 (1):37-44.
    The four principles and consequentialism assist in teasing out moral dilemmas in medicine but often fail to account for the texture of our moral experience. In particular, these ethical approaches fail to account for the moral dilemma and the resultant distress. Conversely, by considering the relationships, emotionality, and motivations of human beings, Simone de Beauvoir's ethics of ambiguity furnishes a more robust ethical analysis and encourages a deeper understanding of how we actually negotiate relationships of care in medicine. I argue (...)
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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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  • 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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  • Moral distress in midwifery practice: A concept analysis.Wendy Foster, Lois McKellar, Julie Fleet & Linda Sweet - 2022 - Nursing Ethics 29 (2):364-383.
    Research suggests that the incidence of moral distress experienced by health professionals is significant and increasing, yet the concept lacks clarity and remains largely misunderstood. Currently, there is limited understanding of moral distress in the context of midwifery practice. The term moral distress was first used to label the psychological distress experienced following complex ethical decision-making and moral constraint in nursing. The term is now used across multiple health professions including midwifery, nursing, pharmacy and medicine, yet is used cautiously due (...)
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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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  • 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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  • ‘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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  • Addressing Moral Distress: lessons Learnt from a Non-Interventional Longitudinal Study on Moral Distress.Trisha M. Prentice, Dilini I. Imbulana, Lynn Gillam, Peter G. Davis & Annie Janvier - 2022 - AJOB Empirical Bioethics 13 (4):226-236.
    Moral distress is prevalent within the neonatal intensive care unit (NICU) and can negatively affect clinicians. Studies have evaluated the causes of moral distress and interventions to mitigate it...
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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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  • Moral distress. [REVIEW]Joan McCarthy & Chris Gastmans - 2015 - Nursing Ethics 22 (1):131-152.
    Aim: The aim of this review is to examine the ways in which the concept of moral distress has been delineated and deployed in the argument-based nursing ethics literature. It adds to what we already know about moral distress from reviews of the qualitative and quantitative research. Data sources: CINAHL, PubMed, Web of Knowledge, EMBASE, Academic Search Complete, PsycInfo, Philosophers’ Index and Socindex. Review methods: A total of 20 argument-based articles published between January 1984 and December 2013 were analysed. Results: (...)
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  • Nurses' perceptions of and responses to morally distressing situations.Colleen Varcoe, Bernie Pauly, Jan Storch, Lorelei Newton & Kara Makaroff - 2012 - Nursing Ethics 19 (4):488-500.
    Research on moral distress has paid limited attention to nurses’ responses and actions. In a survey of nurses’ perceptions of moral distress and ethical climate, 292 nurses answered three open-ended questions about situations that they considered morally distressing. Participants identified a range of situations as morally distressing, including witnessing unnecessary suffering, being forced to provide care that compromised values, and negative judgments about patients. They linked these situations to contextual constraints such as workload and described responses, including feeling incompetent and (...)
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  • Examining moral injury in clinical practice: A narrative literature review.Emily K. Mewborn, Marianne L. Fingerhood, Linda Johanson & Victoria Hughes - 2023 - Nursing Ethics 30 (7-8):960-974.
    Healthcare workers experience moral injury (MI), a violation of their moral code due to circumstances beyond their control. MI threatens the healthcare workforce in all settings and leads to medical errors, depression/anxiety, and personal and occupational dysfunction, significantly affecting job satisfaction and retention. This article aims to differentiate concepts and define causes surrounding MI in healthcare. A narrative literature review was performed using SCOPUS, CINAHL, and PubMed for peer-reviewed journal articles published in English between 2017 and 2023. Search terms included (...)
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  • Experiences of moral distress in a COVID‐19 intensive care unit: A qualitative study of nurses and respiratory therapists in the United States.Sophie Trachtenberg, Tara Tehan, Sara Shostak, Colleen Snydeman, Mariah Lewis, Frederic Romain, Wendy Cadge, Mary Elizabeth McAuley, Cristina Matthews, Laura Lux, Robert Kacmarek, Katelyn Grone, Vivian Donahue, Julia Bandini & Ellen Robinson - 2023 - Nursing Inquiry 30 (1):e12500.
    The COVID‐19 pandemic has placed extraordinary stress on frontline healthcare providers as they encounter significant challenges and risks while caring for patients at the bedside. This study used qualitative research methods to explore nurses and respiratory therapists' experiences providing direct care to COVID‐19 patients during the first surge of the pandemic at a large academic medical center in the Northeastern United States. The purpose of this study was to explore their experiences as related to changes in staffing models and to (...)
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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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  • Conceptualising moral resilience for nursing practice.Tiziana M. L. Sala Defilippis, Katherine Curtis & Ann Gallagher - 2019 - Nursing Inquiry 26 (3):e12291.
    The term ‘moral resilience’ has been gaining momentum in the nursing ethics literature. This may be due to it representing a potential response to moral problems such as moral distress. Moral resilience has been conceptualised as a factor that inhibits immoral actions, as a favourable outcome and as an ability to bounce back after a morally distressing situation. In this article, the philosophical analysis of moral resilience is developed by challenging these conceptualisations and highlighting the risks of such limiting perspectives. (...)
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