Moral distress and moral uncertainty in medical assistance in dying: A simultaneous evolutionary concept analysis

Norwegian nurses' perceptions of assisted dying requests from terminally ill patients—A qualitative interview study

“…Ethical and moral decisions in response to receiving a request for assisted dying may produce conflicts for nurses that can lead to moral uncertainty and moral distress. A concept analysis of moral uncertainty and moral distress performed by Dorman and Bouchal ( 2020 ) explained that moral uncertainty includes a lack of probable and preferable outcomes. Nurses experienced internal conflicts such as feelings of guilt, self‐questioning, and frustration.…”

“…Moral distress includes the inability to take the right action, feelings of powerlessness due to external forces that prevent nurses from acting, and the perception of unnecessary suffering that is not in the best interests of the patient. There is significant overlap between these two concepts, thus influencing how nurses may respond to situations where patients request assisted dying (Dorman & Bouchal, 2020 ).…”

“…According to Dorman and Bouchal ( 2020 ), moral uncertainty implies an inability to decide which course of action to take or to know what outcome is preferable. Our study shows that the majority of the participants lost control and became morally uncertain when receiving the request.…”

“…They were unable to know and decide on what action to take, and additionally, they experienced uncertainty about how to relieve the terminally ill patient's suffering. Dorman and Bouchal ( 2020 ) asserted that moral uncertainty around end‐of‐life outcomes often results in nurses' internal conflicts. They may become less verbal in situations of uncertainty and struggle internally with questions about the correct course of action (Dorman & Bouchal, 2020 ).…”

“…Dorman and Bouchal ( 2020 ) asserted that moral uncertainty around end‐of‐life outcomes often results in nurses' internal conflicts. They may become less verbal in situations of uncertainty and struggle internally with questions about the correct course of action (Dorman & Bouchal, 2020 ).…”