Re-examining the relationship between moral distress and moral agency in nursing.
bioethics
clinical ethics
moral agency
moral distress
moral responsibility
nursing
Journal
Nursing philosophy : an international journal for healthcare professionals
ISSN: 1466-769X
Titre abrégé: Nurs Philos
Pays: England
ID NLM: 100897394
Informations de publication
Date de publication:
07 Feb 2023
07 Feb 2023
Historique:
revised:
21
11
2022
received:
26
08
2022
accepted:
14
01
2023
entrez:
7
2
2023
pubmed:
8
2
2023
medline:
8
2
2023
Statut:
aheadofprint
Résumé
In recent years, the phenomenon of moral distress has been critically examined-and for a good reason. There have been a number of different definitions suggested, some that claimed to be consistent with the original definition but in fact referred to different epistemological states. In this paper, we re-examine moral distress by exploring its relationship with moral agency. We critically examine three conceptions of moral agency and argue that two of these conceptions risk placing nurses' values at the center of moral action when it ought to be the patient's values that shape nurses' obligations. We propose that the conception of moral agency advanced by Aimee Milliken which re-centers patient values, should be more broadly accepted within nursing. We utilize a case example to demonstrate a situation in which the values of a patient's parents (surrogates) justifiably constrained nurses' moral agency, creating moral distress. Through an examination of constraints on nurse agency in this case, we illustrate the problematic nature of 'narrow' moral distress and the value of re-considering moral distress. Finally, we provide an action-oriented proposal identifying mediating steps that we argue have utility for nurses (and other healthcare professionals) to mediate between experiences of narrow moral distress and the exercise of moral agency.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e12419Informations de copyright
© 2023 The Authors. Nursing Philosophy published by John Wiley & Sons Ltd.
Références
American Association of Critical-Care Nurses (AACN). (2006). AACN public policy position statement: Moral distress. American Association of Critical-Care Nurses.
American Nurses Association (ANA). (2015). Code of ethics for nurses. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/
April, C. W., & April, M. D. (2016). Understanding moral distress through the lens of social reflective equilibrium. The American Journal of Bioethics, 16(12), 25-27. https://doi.org/10.1080/15265161.2016.1239788
Bester, J. C. (2019). The best interest standard is the best we have: Why the harm principle and constrained parental autonomy cannot replace the best interest standard in pediatric ethics. The Journal of Clinical Ethics, 30(3), 223-231.
Campbell, S. M., Ulrich, C. M., & Grady, C. (2016). A broader understanding of moral distress. The American Journal of Bioethics, 16(12), 2-9. https://doi.org/10.1080/15265161.2016.1239782
de Casterlé, B. D., Izumi, S., Godfrey, N. S., & Denhaerynck, K. (2008). Nurses' responses to ethical dilemmas in nursing practice: Meta-analysis. Journal of Advanced Nursing, 63(6), 540-549. https://doi.org/10.1111/j.1365-2648.2008.04702.x
Daiski, I. (2004). Changing nurses' dis-empowering relationship patterns. Journal of Advanced Nursing, 48(1), 43-50. https://doi.org/10.1111/j.1365-2648.2004.03167.x
Dudzinski, D. M. (2016). Navigating moral distress using the moral distress map. Journal of Medical Ethics, 42(5), 321-324. https://doi.org/10.1136/medethics-2015-103156
Emami Zeydi, A., Ghazanfari, M. J., Suhonen, R., Adib-Hajbaghery, M., & Karkhah, S. (2022). Effective interventions for reducing moral distress in critical care nurses. Nursing Ethics, 29(4), 1047-1065. https://doi.org/10.1177/09697330211062982
Epstein, E., & Delgado, S. (2010). Understanding and addressing moral distress. OJIN: The Online Journal of Issues in Nursing, 15(3). Advance online publication. https://doi.org/10.3912/OJIN.Vol15No03Man01
Epstein, E. G., Whitehead, P. B., Prompahakul, C., Thacker, L. R., & Hamric, A. B. (2019). Enhancing understanding of moral distress: The measure of moral distress for health care professionals. AJOB Empirical Bioethics, 10(2), 113-124. https://doi.org/10.1080/23294515.2019.1586008
Fourie, C. (2015). Moral distress and moral conflict in clinical ethics. Bioethics, 29(2), 91-97. https://doi.org/10.1111/bioe.12064
Fricker, M. (2007). Epistemic injustice: Power and the ethics of knowing. Oxford University Press.
Goethals, S., Gastmans, C., & de Casterlé, B. D. (2010). Nurses' ethical reasoning and behaviour: A literature review. International Journal of Nursing Studies, 47(5), 635-650. https://doi.org/10.1016/j.ijnurstu.2009.12.010
Haidt, J. (2012). The righteous mind. Penguin Books.
Haidt, J. (2003). The moral emotions. In R. J. Davidson, K. R. Scherer, & H. H. Goldsmith (Eds.), Series in affective science. Handbook of affective sciences (pp. 852-870). Oxford University Press; Scientific Research Publishing. https://www.scirp.org/%28S%28351jmbntvnsjt1aadkozje%29%29/reference/referencespapers.aspx?referenceid=3022095
Hoagland, S. (1992). Lesbian ethics (1st ed.). Institute of Lesbian Studies.
International Council of Nurses (ICN). (2022). Nursing definitions. https://www.icn.ch/nursing-policy/nursing-definitions
Jameton, A. (1984). Nursing practice: The ethical issue. Prentice Hall.
Jameton, A. (1993). Dilemmas of moral distress: Moral responsibility and nursing practice. AWHONN's Clinical Issues in Perinatal and Women's Health Nursing, 4(4), 542-551.
Johnstone, M.-J., & Hutchinson, A. (2015). ‘Moral distress’-Time to abandon a flawed nursing construct? Nursing Ethics, 22(1), 5-14. https://doi.org/10.1177/0969733013505312
Kolbe, L., & de Melo-Martin, I. (2022). Moral distress: What are we measuring? The American Journal of Bioethics. Advance online publication. 1-13. https://doi.org/10.1080/15265161.2022.2044544
Kuhse, H. (1997). Caring: Nurses, women & ethics. Wiley-Blackwell. https://research.monash.edu/en/publications/caring-nurses-women-amp-ethics
McCarthy, J., & Monteverde, S. (2018). The standard account of moral distress and why we should keep it. HEC Forum, 30(4), 319-328. https://doi.org/10.1007/s10730-018-9349-4
McDougall, R., Gillam, L., Spriggs, M., & Delany, C. (2018). The zone of parental discretion and the complexity of paediatrics: A response to Alderson. Clinical Ethics, 13(4), 172-174. https://doi.org/10.1177/1477750918789998
Milliken, A. (2018). Refining moral agency: Insights from moral psychology and moral philosophy. Nursing Philosophy, 19(1), e12185. https://doi.org/10.1111/nup.12185
Morley, G., Bradbury-Jones, C., & Ives, J. (2020a). Moral distress in end-of-life care. In N. Emmerich, P. Mallia, B. Gordijn, & F. Pistoia (Eds.), Contemporary European perspectives on the ethics of end of life care (pp. 335-353). Springer International Publishing. https://doi.org/10.1007/978-3-030-40033-0_22
Morley, G., Bradbury-Jones, C., & Ives, J. (2020b). What is ‘moral distress’ in nursing? A feminist empirical bioethics study. Nursing Ethics, 27(5), 1297-1314. https://doi.org/10.1177/0969733019874492
Morley, G., Bradbury-Jones, C., & Ives, J. (2021a). Reasons to redefine moral distress: A feminist empirical bioethics analysis. Bioethics, 35(1), 61-71. https://doi.org/10.1111/bioe.12783
Morley, G., Bradbury-Jones, C., & Ives, J. (2022). The moral distress model: An empirically informed guide for moral distress interventions, Journal of Clinical Nursing, 31(9-10), 1309-1326. https://doi.org/10.1111/jocn.15988
Morley, G., Field, R., Horsburgh, C. C., & Burchill, C. (2021b). Interventions to mitigate moral distress: A systematic review of the literature. International Journal of Nursing Studies, 121, 103984. https://doi.org/10.1016/j.ijnurstu.2021.103984
Musto, L., Schreiber, R., & Rodney, P. (2021). Risking vulnerability: Enacting moral agency in the is/ought gap in mental health care. Journal of Advanced Nursing, 77(5), 2458-2471. https://doi.org/10.1111/jan.14776
Musto, L. C., Rodney, P. A., & Vanderheide, R. (2015). Toward interventions to address moral distress: Navigating structure and agency. Nursing Ethics, 22(1), 91-102. https://doi.org/10.1177/0969733014534879
Newham, R. (2021). Morality, normativity and measuring moral distress. Nursing Philosophy, 22(1), e12319. https://doi.org/10.1111/nup.12319
Paley, J. (2004). Commentary: The discourse of moral suffering. Journal of Advanced Nursing, 47(4), 364-365. https://doi.org/10.1111/j.1365-2648.2004.03113_2.x
Peter, E., & Liaschenko, J. (2004). Perils of proximity: A spatiotemporal analysis of moral distress and moral ambiguity. Nursing Inquiry, 11(4), 218-225. https://doi.org/10.1111/j.1440-1800.2004.00236.x
Riaz, S. H., Sankary, L. R., Brown, T. E., & Morley, G. (2022). Deconstructing structural injustices in the clinic, classroom, and boardroom. The American Journal of Bioethics, 22(3), 29-32. https://doi.org/10.1080/15265161.2022.2027564
Robinson, E. M., Lee, S. M., Zollfrank, A., Jurchak, M., Frost, D., & Grace, P. (2014). Enhancing moral agency: Clinical ethics residency for nurses. Hastings Center Report, 44(5), 12-20. https://doi.org/10.1002/hast.353
Rodney, P., Brown, H., & Liaschenko, J. (2004). Moral agency: Relational connections and trust. In J. L. Storch, P. Rodney, & R. C. Starzomski (Eds.), Toward a moral horizon: Nursing ethics for leadership and practice (1st ed, pp. 154-177). Pearson Prentice Hall.
Sherwin, S. (1998). A relational approach to autonomy in health care. In S. Sherwin, & the Feminist Health Care Ethics Research Network (Eds.), The politics of women's health (pp. 19-47). Temple University Press.
Stocker, M. (1990). Plural and conflicting values. Clarendon Press.
Tessman, L. (2014). Moral failure: On the impossible demands of morality. Oxford University Press. https://doi.org/10.1093/acprof:oso/9780199396146.001.0001
Traudt, T., Liaschenko, J., & Peden-McAlpine, C. (2016). Moral agency, moral imagination, and moral community: Antidotes to moral distress. The Journal of Clinical Ethics, 27(3), 201-13.
Yarling, R. R., & McElmurry, B. J. (1986). The moral foundation of nursing. Advances in Nursing Science, 8(2), 63-74. https://doi.org/10.1097/00012272-198601000-00010