The Role of Responsibility in Moral Distress

Gorin, Moti

doi:10.1080/15265161.2016.1239792

Cited by 6 publications

(5 citation statements)

References 3 publications

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“…The importance of moral responsibility as applied to moral distress has been highlighted by other authors. Gorin (2016) suggests that Campbell et al.,'s (2016) broad definition should stipulate a feeling of moral responsibility between the individual experiencing moral distress and the morally desirable situation. Both Gorin (2016) and Dudzinski (2016) suggest that moral responsibility helps us to distinguish between moral distress and distress simpliciter .…”

Section: Resultsmentioning

confidence: 99%

“…Gorin (2016) suggests that Campbell et al.,'s (2016) broad definition should stipulate a feeling of moral responsibility between the individual experiencing moral distress and the morally desirable situation. Both Gorin (2016) and Dudzinski (2016) suggest that moral responsibility helps us to distinguish between moral distress and distress simpliciter . Dudzinski (2016)suggests that moral distress is accompanied by a heightened feeling of moral responsibility and often the feeling that responsibilities are conflicting.…”

Section: Resultsmentioning

confidence: 99%

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The moral distress model: An empirically informed guide for moral distress interventions

Morley

Bradbury‐Jones

Ives

2021

Journal of Clinical Nursing

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Aims and Objectives:To explore moral distress empirically and conceptually, to understand the factors that mitigate and exacerbate moral distress and construct a model that represents how moral distress relates to its constituent parts and related concepts.Background: There is ongoing debate about how to understand and respond to moral distress in nursing practice. Design:The overarching design was feminist empirical bioethics in which feminist interpretive phenomenology provided the tools for data collection and analysis, reported following the COREQ guidelines. Using reflexive balancing, the empirical data were combined with feminist theory to produce normative recommendations about how to respond to moral distress. The Moral Distress Model presented in this paper is a culmination of the empirical data and theory.Methods: Using feminist interpretive phenomenology, critical care nurses in the United Kingdom (n = 21) were interviewed and data analysed. Reflexive Balancing was used to integrate the data with feminist theory to provide normative recommendations about how to understand moral distress.Results: There are five compounding factors that exacerbate/ mitigate nurses' experiences of moral distress: epistemic injustice; the roster lottery; conflict between one's professional and personal responsibilities; ability to advocate and team dynamics. In addition to the causal connection and responses to moral distress, these factors make up the moral distress model which can guide approaches to mitigate moral distress. Conclusions:The Moral Distress Model is the culmination of these data and theorising formulated into a construct to explain how each element interacts. We propose

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The moral distress model: An empirically informed guide for moral distress interventions

Morley

Bradbury‐Jones

Ives

2021

Journal of Clinical Nursing

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“…Corley, 42 Kopala and Burkhart, 43 Cohen and Erickson, 11 Austin et al, 44 Cox, 45 Epstein and Delgado, 46 Epstein and Hamric, 47 Lützén and Kvist, 48 Lützén and Ewalds-Kvist, 49 Bennett and Chamberlin, 50 Carnevale, 10 Carse, 51 Dudzinski, 52 Gorin, 53 Latham, 54 and Mare s 55 Lower quality (n¼8) Hamric, 56 Corley and Minick, 57 Erlen, 58 Hamric, 59 Barlem et al, 13 Barlem and Ramos, 60 Burgart and Kruse, 61 63 -MDQ (Moral Distress Questionnaire),Pavlish et al 64 -Ethics Screening and Early Intervention Tool,Pavlish et al 65 -Screening tool for risk or ethical conflicts,Schaefer et al 66 One-tenth of the coded articles were checked (MA, PB) and disagreements were resolved by discussion and consensus.…”

Section: Moderate Quality (N¼16)mentioning

confidence: 99%

Re-defining moral distress: A systematic review and critical re-appraisal of the argument-based bioethics literature

et al. 2019

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The concept of moral distress comes from nursing ethics, and was initially defined as ‘…when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action’. There is a large body of literature associated with moral distress, yet multiple definitions now exist, significantly limiting its usefulness. We undertook a systematic review of the argument-based bioethics literature on this topic as the basis for a critical appraisal, identifying 55 papers for analysis. We found that moral distress is most frequently framed around individual experiences of distress in relation to local practices and constraints, and understood in terms of power relations and workplace hierarchies. This understanding is directly derived from, and often still seen as specific to, nursing. Frequently the perspective of the morally distressed individual is privileged. Understandings of moral distress have evolved towards an ‘occupational health approach’, with the assumption that moral distress should be measured and prevented. Counter-perspectives were identified, highlighting conceptual problems. Based on our review, we propose a redefinition of moral distress: ‘Ethical unease or disquiet resulting from a situation where a clinician believes they have contributed to avoidable patient or community harm through their involvement in an action, inaction or decision that conflicts with their own values’. This definition is specific enough for research use, anchored in clinicians’ professional responsibilities and concerns about harms to patients, framed relationally rather than hierarchically, and amenable to multiple perspectives on any given morally distressing situation.

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“…Naturally, it is also possible that a practitioner who feels unable to practice according to the moral code of her profession does not, for some reason, feel anguished by it. This may, for example, be due to lack of moral sensitivity (see Lützén and Kvist, 2012) or lack of moral responsibility (see Gorin, 2016). Thus, it is reasonable to argue that both elements of moral distress need to be present.…”

Section: Distressmentioning

confidence: 99%

“…At the level of practice, the goal should not be to ameliorate experiences of moral distress per se but rather to remove the obstacles to moral action and to enhance moral agency (see e.g. Varcoe et al, 2012;Fourie, 2016;Dudzinski 2016;Fourie, 2016;Gorin 2016;McFadden et al, 2018).…”

Section: Towards Broader More Subjective and Relative Conceptualisations?mentioning

confidence: 99%

Conceptualising Work-Related Moral Suffering—Exploring and Refining the Concept of Moral Distress in the Context of Social Work

Kuip

2019

The British Journal of Social Work

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In the nursing literature, work-related suffering due to restricted moral agency is commonly considered under the concept of moral distress. This concept has resonated strongly amongst nursing scholars since the 1980s and has recently gained ground amongst social work scholars as well. However, the research on moral distress suffers from inadequate conceptual clarity; this has led to multiple and disparate ways of empirically studying the phenomenon. This article examines the conceptualisations of moral distress applied in the nursing and social work literature and identifies and discusses the challenges and potential problems related to them. The article sheds light on the complex, dynamic and relative nature of the phenomenon, which has not been sufficiently acknowledged in the existing empirical literature. Despite its complexities and defects, as highlighted in this article, the concept of moral distress can serve as an important tool for understanding and analysing experiences of moral suffering in front line social work. However, defining this experience in all its complexity and devising a valid instrument to measure it remain a major challenge.

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The Role of Responsibility in Moral Distress

Cited by 6 publications

References 3 publications

The moral distress model: An empirically informed guide for moral distress interventions

The moral distress model: An empirically informed guide for moral distress interventions

Re-defining moral distress: A systematic review and critical re-appraisal of the argument-based bioethics literature

Conceptualising Work-Related Moral Suffering—Exploring and Refining the Concept of Moral Distress in the Context of Social Work

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