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  1. Moral Stress and Moral Distress: Confronting Challenges in Healthcare Systems under Pressure.Mara Buchbinder, Alyssa Browne, Nancy Berlinger, Tania Jenkins & Liza Buchbinder - forthcoming - American Journal of Bioethics:1-15.
    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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  • Disruptive Innovation and Moral Uncertainty.Philip J. Nickel - 2020 - NanoEthics 14 (3):259-269.
    This paper develops a philosophical account of moral disruption. According to Robert Baker, moral disruption is a process in which technological innovations undermine established moral norms without clearly leading to a new set of norms. Here I analyze this process in terms of moral uncertainty, formulating a philosophical account with two variants. On the harm account, such uncertainty is always harmful because it blocks our knowledge of our own and others’ moral obligations. On the qualified harm account, there is no (...)
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  • Disruptive Innovation and Moral Uncertainty.Philip J. Nickel - forthcoming - NanoEthics: Studies in New and Emerging Technologies.
    This paper develops a philosophical account of moral disruption. According to Robert Baker (2013), moral disruption is a process in which technological innovations undermine established moral norms without clearly leading to a new set of norms. Here I analyze this process in terms of moral uncertainty, formulating a philosophical account with two variants. On the Harm Account, such uncertainty is always harmful because it blocks our knowledge of our own and others’ moral obligations. On the Qualified Harm Account, there is (...)
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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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  • Moral Distress and Austerity: An Avoidable Ethical Challenge in Healthcare.Georgina Morley, Jonathan Ives & Caroline Bradbury-Jones - 2019 - Health Care Analysis 27 (3):185-201.
    Austerity, by its very nature, imposes constraints by limiting the options for action available to us because certain courses of action are too costly or insufficiently cost effective. In the context of healthcare, the constraints imposed by austerity come in various forms; ranging from the availability of certain treatments being reduced or withdrawn completely, to reductions in staffing that mean healthcare professionals must ration the time they make available to each patient. As austerity has taken hold, across the United Kingdom (...)
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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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  • Response to Open Peer Commentaries on “A Broader Understanding of Moral Distress”.Stephen M. Campbell, Connie M. Ulrich & Christine Grady - 2016 - American Journal of Bioethics 16 (12):1-3.
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