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  1. To stay or to go, to speak or stay silent, to act or not to act: Moral distress as experienced by psychologists.Wendy Austin, Marlene Rankel, Leon Kagan, Vangie Bergum & Gillian Lemermeyer - 2005 - Ethics and Behavior 15 (3):197 – 212.
    The moral distress of psychologists working in psychiatric and mental health care settings was explored in an interdisciplinary, hermeneutic phenomenological study situated at the University of Alberta, Canada. Moral distress is the state experienced when moral choices and actions are thwarted by constraints. Psychologists described specific incidents in which they felt their integrity had been compromised by such factors as institutional and interinstitutional demands, team conflicts, and interdisciplinary disputes. They described dealing with the resulting moral distress by such means as (...)
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  • Consequences of clinical situations that cause critical care nurses to experience moral distress.D. L. Wiegand & M. Funk - 2012 - Nursing Ethics 19 (4):479-487.
    Little is known about the consequences of moral distress. The purpose of this study was to identify clinical situations that caused nurses to experience moral distress, to understand the consequences of those situations, and to determine whether nurses would change their practice based on their experiences. The investigation used a descriptive approach. Open-ended surveys were distributed to a convenience sample of 204 critical care nurses employed at a university medical center. The analysis of participants’ responses used an inductive approach and (...)
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  • Ethical conflicts with hospitals: The perspective of nurses and physicians.A. Gaudine, S. M. LeFort, M. Lamb & L. Thorne - 2011 - Nursing Ethics 18 (6):756-766.
    Nurses and physicians may experience ethical conflict when there is a difference between their own values, their professional values or the values of their organization. The distribution of limited health care resources can be a major source of ethical conflict. Relatively few studies have examined nurses' and physicians' ethical conflict with organizations. This study examined the research question ‘What are the organizational ethical conflicts that hospital nurses and physicians experience in their practice?’ We interviewed 34 registered nurses, 10 nurse managers, (...)
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  • Moral Distress: A Growing Problem in the Health Professions?Connie M. Ulrich, Ann B. Hamric & Christine Grady - 2010 - Hastings Center Report 40 (1):20-22.
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  • Organizational ethics in healthcare organizations: Proactively managing the ethical climate to ensure organizational integrity. [REVIEW]Henry J. Silverman - 2000 - HEC Forum 12 (3):202-215.
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  • Moral Distress, Moral Residue, and the Crescendo Effect.Elizabeth Gingell Epstein & Ann Baile Hamric - 2009 - Journal of Clinical Ethics 20 (4):330-342.
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  • Bioethics: a systematic approach.Bernard Gert - 2006 - New York: Oxford University Press. Edited by Charles M. Culver & K. Danner Clouser.
    This book is the result of over 30 years of collaboration among its authors. It uses the systematic account of our common morality developed by one of its authors to provide a useful foundation for dealing with the moral problems and disputes that occur in the practice of medicine. The analyses of impartiality, rationality, and of morality as a public system not only explain why some bioethical questions, such as the moral acceptability of abortion, cannot be resolved, but also provide (...)
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  • Ethics Consultation in the Emergency Department.Lisa Anderson-Shaw, William Ahrens & Marny Fetzer - 2007 - Jona's Healthcare Law, Ethics, and Regulation 9 (1):32-35.
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  • Moral Distress and the Contemporary Plight of Health Professionals.Wendy Austin - 2012 - HEC Forum 24 (1):27-38.
    Once a term used primarily by moral philosophers, “moral distress” is increasingly used by health professionals to name experiences of frustration and failure in fulfilling moral obligations inherent to their fiduciary relationship with the public. Although such challenges have always been present, as has discord regarding the right thing to do in particular situations, there is a radical change in the degree and intensity of moral distress being expressed. Has the plight of professionals in healthcare practice changed? “Plight” encompasses not (...)
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  • An Evaluation of Unit-Based Ethics Conversations.Lucia D. Wocial, Maureen Hancock, Patricia D. Bledsoe, Amy R. Chamness & Paul R. Helft - 2010 - Jona's Healthcare Law, Ethics, and Regulation 12 (2):48-54.
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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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  • Shared Moral Work of Nurses and Physicians.Janet L. Storch & Nuala Kenny - 2007 - Nursing Ethics 14 (4):478-491.
    Physicians and nurses need to sustain their unique strengths and work in true collaboration, recognizing their interdependence and the complementarity of their knowledge, skills and perspectives, as well as their common moral commitments. In this article, challenges often faced by both nurses and physicians in working collaboratively are explored with a focus on the ways in which each profession's preparation for practice has differed over time, including shifts in knowledge development and codes of ethics guiding their practice. A call for (...)
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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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  • Emotions and Clinical Ethics Support. A Moral Inquiry into Emotions in Moral Case Deliberation.Bert Molewijk, Dick Kleinlugtenbelt, Scott M. Pugh & Guy Widdershoven - 2011 - HEC Forum 23 (4):257-268.
    Emotions play an important part in moral life. Within clinical ethics support (CES), one should take into account the crucial role of emotions in moral cases in clinical practice. In this paper, we present an Aristotelian approach to emotions. We argue that CES can help participants deal with emotions by fostering a joint process of investigation of the role of emotions in a case. This investigation goes beyond empathy with and moral judgment of the emotions of the case presenter. In (...)
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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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  • Ethics and the Structures of Healthcare.Linda L. Emanuel - 2000 - Cambridge Quarterly of Healthcare Ethics 9 (2):151-168.
    Suppose a meeting had been called among chief medical officers, chief administrative officers, and other leaders from a range of health-related institutions in this country. The question posed for this meeting was simple but unusual: Arethestructuresofourorganizations,systems,andinstitutionsethical? Though it was a question reminiscent for a few of the focus some time before on whether the conduct of individuals in their organization was ethical, this question seemed more demanding. Is it reasonable to consider structures or arrangements as ethical or not; or in (...)
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  • Communication and conflict management training for clinical bioethics committees.M. Edelstein Lauren, G. DeRenzo Evan, Craig Zelizer Elizabeth Waetzig & O. Mokwunye Nneka - 2009 - HEC Forum 21 (4):341-349.
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  • Facilitated Ethics Conversations.Paul R. Helft, Patricia D. Bledsoe, Maureen Hancock & Lucia D. Wocial - 2009 - Jona's Healthcare Law, Ethics, and Regulation 11 (1):27-33.
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  • Ethical Challenges Within Veterans Administration Healthcare Facilities: Perspectives of Managers, Clinicians, Patients, and Ethics Committee Chairpersons.Mary Beth Foglia, Robert A. Pearlman, Melissa Bottrell, Jane K. Altemose & Ellen Fox - 2009 - American Journal of Bioethics 9 (4):28-36.
    To promote ethical practices, healthcare managers must understand the ethical challenges encountered by key stakeholders. To characterize ethical challenges in Veterans Administration (VA) facilities from the perspectives of managers, clinicians, patients, and ethics consultants. We conducted focus groups with patients (n = 32) and managers (n = 38); semi-structured interviews with managers (n = 31), clinicians (n = 55), and ethics committee chairpersons (n = 21). Data were analyzed using content analysis. Managers reported that the greatest ethical challenge was fairly (...)
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  • Communication and Conflict Management Training for Clinical Bioethics Committees.Lauren M. Edelstein, Evan G. DeRenzo, Elizabeth Waetzig, Craig Zelizer & Nneka O. Mokwunye - 2009 - HEC Forum 21 (4):341-349.
    Communication and Conflict Management Training for Clinical Bioethics Committees Content Type Journal Article Pages 341-349 DOI 10.1007/s10730-009-9116-7 Authors Lauren M. Edelstein, Johns Hopkins Medicine’s Howard County General Hospital 5755 Cedar Lane Columbia MD 21044 USA Evan G. DeRenzo, Washington Hospital Center Center for Ethics 110 Irving St Washington, D.C. NW 20010 USA Elizabeth Waetzig, Change Matrix Inc. 485 Maylin St. Pasadena CA 91105 USA Craig Zelizer, Georgetown University Department of Government 3240 Prospect St. Washington, D.C. NW 20057 USA Nneka O. (...)
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  • Defense Mechanisms in Ethics Consultation.George J. Agich - 2011 - HEC Forum 23 (4):269-279.
    While there is no denying the relevance of ethical knowledge and analytical and cognitive skills in ethics consultation, such knowledge and skills can be overemphasized. They can be effectively put into practice only by an ethics consultant, who has a broad range of other skills, including interpretive and communicative capacities as well as the capacity effectively to address the psychosocial needs of patients, family members, and healthcare professionals in the context of an ethics consultation case. In this paper, I discuss (...)
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