Abstract
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 only the act of pledging, but that of predicament and peril. The author claims that health professionals are increasingly put in peril by healthcare reform that undermines their efficacy and jeopardizes ethical engagement with those in their care. The re-engineering of healthcare to give precedence to corporate and commercial values and strategies of commodification, service rationing, streamlining, and measuring of “efficiency,” is literally demoralizing health professionals. Healthcare practice needs to be grounded in a capacity for compassion and empathy, as is evident in standards of practice and codes of ethics, and in the understanding of what it means to be a professional. Such grounding allows for humane response to the availability of unprecedented advances in biotechnological treatments, for genuine dialogue and the raising of difficult, necessary ethical questions, and for the mutual support of health professionals themselves. If healthcare environments are not understood as moral communities but rather as simulated marketplaces, then health professionals’ moral agency is diminished and their vulnerability to moral distress is exacerbated. Research in moral distress and relational ethics is used to support this claim.
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Notes
Personal communication, 29 March 2007.
Publication is forthcoming. For a related article, please see Austin et al. (2009a).
This PICU patient situation is common enough that its description here does not create risk for identification of the baby nor the PICU.
Between a Rock and a Hard Place: When Healthcare Providers Experience Moral Distress, hosted by the Provincial Health Ethics Network and the College and Association of Registered Nurses of Alberta, 23 May 2008, Calgary, Alberta. This conference was so oversubscribed that it was repeated later in 2008—an indication of the local level of interest and concern regarding health professionals’ moral distress.
Available at the library of the Wellcome Trust as MS 8520. See http://library.wellcome.ac.uk/doc_WTX041077.html.
“The more things change, the more they remain the same.”
Doctors Without Borders.
Publication is forthcoming. For a related article, please see Austin et al. (2009a).
Between a Rock and a Hard Place, 23 May 2008.
Publication is forthcoming. For a related article, please see Austin et al. (2009a).
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Austin, W. Moral Distress and the Contemporary Plight of Health Professionals. HEC Forum 24, 27–38 (2012). https://doi.org/10.1007/s10730-012-9179-8
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DOI: https://doi.org/10.1007/s10730-012-9179-8