HEC Forum

, Volume 30, Issue 4, pp 319–328 | Cite as

The Standard Account of Moral Distress and Why We Should Keep It

  • Joan McCarthyEmail author
  • Settimio Monteverde


In the last three decades, considerable theoretical and empirical research has been undertaken on the topic of moral distress among health professionals. Understood as a psychological and emotional response to the experience of moral wrongdoing, there is evidence to suggest that—if unaddressed—it contributes to staff demoralization, desensitization and burnout and, ultimately, to lower standards of patient safety and quality of care. However, more recently, the concept of moral distress has been subjected to important criticisms. Specifically, some authors argue that the standard account of moral distress elucidated by Jameton (AWHONN’s Clin Issues Perinat Women’s Health 4(4):542–551, 1984) does not refer to a discrete phenomenon and/or that it is not sufficiently broad and that this makes measuring its prevalence among health professionals, and other groups of workers, difficult if not impossible. In this paper, we defend the standard account of moral distress. We understand it as a concept that draws attention to the social, political and contextual determinants of moral agency and brings the emotional landscape of the moral realm to the fore. Given the increasing pressure on health professionals worldwide to meet efficiency, financial and corporate targets and reported adverse effects of these for the quality and safety of patient care, we believe that further empirical research that deploys the standard account moral distress is timely and important.


Moral distress Moral constraint Nursing Health professional Moral emotion 


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© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Nursing and Midwifery, College of Medicine and HealthUniversity College CorkCorkIreland
  2. 2.Institute of Biomedical Ethics and History of MedicineUniversity of ZurichZurichSwitzerland

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