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      Moral Distress: Allgegenwärtig, erschöpfend erforscht und nun?

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      Pflege
      Hogrefe Publishing Group

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          A Broader Understanding of Moral Distress

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            ‘Moral distress’ – time to abandon a flawed nursing construct?

            Moral distress has been characterised in the nursing literature as a major problem affecting nurses in all healthcare systems. It has been portrayed as threatening the integrity of nurses and ultimately the quality of patient care. However, nursing discourse on moral distress is not without controversy. The notion itself is conceptually flawed and suffers from both theoretical and practical difficulties. Nursing research investigating moral distress is also problematic on account of being methodologically weak and disparate. Moreover, the ultimate purpose and significance of the research is unclear. In light of these considerations, it is contended that the notion of moral distress ought to be abandoned and that concerted attention be given to advancing inquiries that are more conducive to improving the quality and safety of moral decision-making, moral conduct and moral outcomes in nursing and healthcare domains.
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              The Standard Account of Moral Distress and Why We Should Keep It.

              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.
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                Author and article information

                Journal
                Pflege
                Pflege
                Hogrefe Publishing Group
                1012-5302
                1664-283X
                August 2023
                August 2023
                : 36
                : 4
                : 187-188
                Affiliations
                [1 ]Institut für Ethik und Geschichte der Medizin, Universitätsmedizin Greifswald, Deutschland
                Article
                10.1024/1012-5302/a000945
                bc83cb8c-4443-42ad-a815-300bdb8f31c1
                © 2023
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