What is ‘moral distress’? A narrative synthesis of the literature

Nursing Ethics

Volumn 26, Issue 3, 2019, Pages 646-662

  Morley, Georgina ^a   Ives, Jonathan ^a   Bradbury Jones, Caroline ^b   Irvine, Fiona ^b  

^a UNIVERSITY OF BRISTOL   (United Kingdom)

^b UNIVERSITY OF BIRMINGHAM   (United Kingdom)

Author keywords

Bioethics; empirical approaches; literature review; moral distress; narrative synthesis; nursing; nursing ethics

Indexed keywords

BIOETHICS; BURNOUT; COMPLICATION; CONCEPT FORMATION; ETIOLOGY; HUMAN; MENTAL STRESS; POSTTRAUMATIC STRESS DISORDER; PSYCHOLOGY; TRENDS;

BIOETHICS; BURNOUT, PROFESSIONAL; CONCEPT FORMATION; HUMANS; STRESS DISORDERS, POST-TRAUMATIC; STRESS, PSYCHOLOGICAL;

EID: 85065701736     PISSN: 09697330     EISSN: 14770989     Source Type: Journal    
DOI: 10.1177/0969733017724354     Document Type: Review

References (50)

1. Jameton A. Nursing practice: the ethical issues. Englewood Cliffs, NJ: Prentice Hall, 1984, p. 6.
2. Pauly B, Varcoe C, Storch J. Registered nurses’ perceptions of moral distress and ethical climate. Nurs Ethics 2009; 16: 561–573.
3. Maiden J, Georges JM, Connelly CD. Perceptions about medication errors in certified critical care nurses. Dimens Crit Care Nurs 2011; 30: 339–345.
4. Mason VM, Leslie G, Clark K. Compassion fatigue, moral distress, and work engagement in surgical intensive care unit trauma nurses: a pilot study. Dimens Crit Care Nurs 2014; 33: 215–225.
5. Wilkinson JM. Moral distress in nursing practice: experience and effect. Nurs Forum 1988; 23: 16–29.
6. Whitehead PB, Herbertson RK, Hamric AB. Moral distress among healthcare professionals: report of an institution-wide survey. J Nurs Scholarsh 2014; 47: 117–125.
7. Hamric AB. Empirical research on moral distress: issues, challenges, and opportunities. HEC Forum 2012; 24: 39–49.
8. Hanna DR. Moral distress: the state of the science. Research and Theory for Nursing Practice: An International Journal 2004; 18: 76.
9. McCarthy J, Deady R. Moral distress reconsidered. Nurs Ethics 2008; 15: 254–262.
10. Mackie JL. Causes and conditions. Am Philos Quart 1965; 2: 245–264.
11. Thorne S. Metasynthetic madness: what kind of monster have we created? Qual Health Res 2017; 27: 3–12.
12. Strech D, Synofzik M, Marckmann G. Systematic reviews of empirical bioethics. J Med Ethics 2008; 34: 472–477.
13. Popay J, Roberts H, Sowden A. Guidance on the conduct of narrative synthesis in systematic reviews: a product from the ESRC methods programme. Lancaster University, 2006, http://www.lancaster.ac.uk/shm/research/nssr/research/dissemination/publications/NS_Synthesis_Guidance:v1.pdf
14. Whittemore R, Knafl K. The integrative review: updated methodology. J Adv Nurs 2005; 52: 546–553.
15. Strech D. Evidence-based ethics – what it should be and what it shouldn’t. BMC Med Ethics 2008; 9: 16.
16. Jameton A. Dilemmas of moral distress: moral responsibility and nursing practice. AWHONNS Clin Issues Perinat Womens Health Nurs 1993; 4: 542–551.
17. Corley MC. Moral distress of critical care nurses. Am J Crit Care 1995; 4: 280–285.
18. Corley MC, Elswick RK, Gorman M, Clor T. Development and evaluation of a moral distress scale. J adv Nurs 2001; 33: 250–256.
19. Kälvemark S, Höglund AT, Hansson MG. Living with conflicts – ethical dilemmas and moral distress in the health care system. Soc Sci Med 2004; 58: 1082–1083.
20. Peter E, Liaschenko J. Perils of proximity: a spatiotemporal analysis of moral distress and moral ambiguity. Nurs Inq 2004; 11: 221.
21. Corley MC, Minick P, Elswick R. Nurse moral distress and ethical work environment. Nurs Ethics 2005; 12: 382.
22. Jameton A. A reflection on moral distress in nursing together with a current application of the concept. J Bioeth Inq 2013; 10: 297–308.
23. Astbury JL, Gallagher CT, O’Neill RC. The issue of moral distress in community pharmacy practice: background and research agenda. Int J Pharm Pract 2015; 23: 361–366, 457.
24. Barlem ELD, Ramos FRS. Constructing a theoretical model of moral distress. Nurs Ethics 2015; 22: 608–615.
25. Fourie C. Moral distress and moral conflict in clinical ethics. Bioethics 2015; 29: 91–97.
26. Campbell SM, Ulrich CM, Grady C. A broader understanding of moral distress. Am J Bioeth 2016; 16: 2–9.
27. Peter E, Mohammed S, Simmonds A. Narratives of aggressive care: knowledge, time, and responsibility. Nurs Ethics 2014; 21: 461–472.
28. Wilkinson JM. Moral distress: a labor and delivery nurse’s experience. J Obstet Gynecol Neonatal Nurs 1989; 18: 513–519.
29. Wiegand DL, Funk M. Consequences of clinical situations that cause critical care nurses to experience moral distress. Nurs Ethics 2012; 19: 479–487.
30. Weinberg M. Moral distress: a missing but relevant concept for ethics in social work. Can Soc Work Rev 2009; 26: 139–151.
31. Pauly B, Varcoe C, Storch J. Framing the issues: moral distress in health care. HEC Forum 2012; 24: 1–11.
32. Hamric A, Borchers C, Epstein E. Development and testing of an instrument to measure moral distress in healthcare professionals. AJOB Prim Res 2012; 3: 1–9.
33. Browning A. Moral distress and psychological empowerment in critical care nurses caring for adults at end of life. Am J Crit Care 2013; 22: 143–151.
34. McDaniel C. Development and psychometric properties of the ethics environment questionnaire. Med Care 1997; 35: 901–914.
35. Hamric A, Blackhall L. Nurse-physician perspectives on the care of dying patients in intensive care units: collaboration, moral distress, and ethical climate. Crit Care Med 2007; 35: 422–429.
36. Silén M, Svantesson M, Kjellström S. Moral distress and ethical climate in a Swedish nursing context: perceptions and instrument usability. J Clin Nurs 2011; 20: 3483–3493.
37. Musto L, Rodney P. Moving from conceptual ambiguity to knowledgeable action: using a critical realist approach to studying moral distress. Nurs Philos 2015; 17: 1–13.
38. Peter E, Liaschenko J. Moral distress reexamined: a feminist interpretation of nurses’ identities, relationships, and responsibilities. J Bioeth Inq 2013; 10: 337–445.
39. Epstein E, Hamric A. Moral distress, moral residue, and the crescendo effect. J Clin Ethics 2009; 20: 330–342.
40. Reed PG, Rishel CJ. Epistemic injustice and nurse moral distress: perspective for policy development. Nurs Sci Quart 2015; 28: 241–244.
41. Fricker M. Epistemic injustice: power and the ethics of knowing. Oxford: Oxford University Press, 2007, p. 2.
42. American Association of Critical-Care Nurses A. AACN Public Policy Position Statement: Moral Distress. Aliso Viejo, CA: American Association of Critical-Care Nurses (AACN), 2006.
43. Hamric AB. A case study of moral distress. J Hosp Palliat Nurs 2014; 16: 457–463.
44. Thomas T, McCullough L. A philosophical taxonomy of ethically significant moral distress. J Med Philos 2015; 40: 102–120.
45. Beauchamp TL, Childress JF. Principles of biomedical ethics. 7th ed. New York: Oxford University Press, 2013, p. 40.
46. Hardingham L. Integrity and moral residue: nurses as participants in a moral community. Nurs Philos 2004; 5: 127–134.
47. Corley MC. nurse moral distress: a proposed theory and research agenda. Nurs Ethics 2002; 6.
48. Nathaniel A. Moral Reckoning in Nursing. West J Nurs Res 2006; 28: 419–438.
49. Canadian Nurses Association C. Code of Ethics for Registered Nurses. Ottawa; 2008.
50. McCarthy J. Nursing Ethics and Moral Distress: the story so far. Nurs Ethics 2013. (Special Online Issue) (accessed 23 May 2016).