Ethical Reasoning and Moral Distress in Social Care Among Long-Term Care Staff

Abstract

There are studies on the normative ethical frameworks used by long-term care staff and studies proposing how staff should reason, but few studies explore how staff actually reason. This study reports on the ethical reasoning process and experiences of moral distress of long-term care staff in the provision of social care. Seven interdisciplinary focus groups were conducted with twenty front-line staff. Staff typically did not have difficulty determining the ethical decision and/or action; however, they frequently experience moral distress. To manage these experiences of moral distress in making ethical decisions, staff 1) comply with being told what to do out of fear of consequences, 2) defer decisions to family, 3) “have a meeting,” 4) socialization into and acceptance of workplace culture. Findings suggest that to better understand how and why staff make ethical decisions and improve quality and ethical care, we must explore the interaction between front-line practice and organizational and public policy.

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Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The research was supported by Mitacs Accelerate Internship and the Social Sciences and Humanities Research Council [Joseph Armand Bombardier Canada Graduate Scholarship-Master’s].

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Correspondence to Michelle Greason.

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Greason, M. Ethical Reasoning and Moral Distress in Social Care Among Long-Term Care Staff . Bioethical Inquiry 17, 283–295 (2020). https://doi.org/10.1007/s11673-020-09974-x

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Keywords

  • Ethical reasoning
  • Empirical ethics
  • Moral distress
  • Long-term care
  • Quality care
  • Ethics policy