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Medicine, Health Care and Philosophy

, Volume 21, Issue 4, pp 479–488 | Cite as

Rethinking moral distress: conceptual demands for a troubling phenomenon affecting health care professionals

  • Daniel W. Tigard
Scientific Contribution

Abstract

Recent medical and bioethics literature shows a growing concern for practitioners’ emotional experience and the ethical environment in the workplace. Moral distress, in particular, is often said to result from the difficult decisions made and the troubling situations regularly encountered in health care contexts. It has been identified as a leading cause of professional dissatisfaction and burnout, which, in turn, contribute to inadequate attention and increased pain for patients. Given the natural desire to avoid these negative effects, it seems to most authors that systematic efforts should be made to drastically reduce moral distress, if not altogether eliminate it from the lives of vulnerable practitioners. Such efforts, however, may be problematic, as moral distress is not adequately understood, nor is there agreement among the leading accounts regarding how to conceptualize the experience. With this article I make clear what a robust account of moral distress should be able to explain and how the most common notions in the existing literature leave significant explanatory gaps. I present several cases of interest and, with careful reflection upon their distinguishing features, I establish important desiderata for an explanatorily satisfying account. With these fundamental demands left unsatisfied by the leading accounts, we see the persisting need for a conception of moral distress that can capture and delimit the range of cases of interest.

Keywords

Moral distress Nursing ethics Emotions Moral psychology 

Notes

Acknowledgements

For support during the research and writing of this paper, I thank the Murphy Institute’s Center for Ethics and Public Affairs at Tulane University. For helpful comments or conversations on issues addressed here, I greatly appreciate Nathan Biebel, Alison Denham, Georgina Morley, David Shoemaker, Chad Van Schoelandt, and two anonymous reviewers for this journal.

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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of PhilosophyTulane UniversityNew OrleansUSA

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