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  1. Unveiling nurses’ end-of-life care experiences: Moral distress and impacts.Myung Nam Lee, So-Hi Kwon, SuJeong Yu, Sook Hyun Park, Sinyoung Kwon, Cho Hee Kim, Myung-Hee Park, Sung Eun Choi, Sanghee Kim & Sujeong Kim - 2024 - Nursing Ethics 31 (8):1600-1615.
    Background Nurses providing care to patients with end-of-life or terminal illnesses often encounter ethically challenging situations leading to moral distress. However, existing quantitative studies have examined moral distress using instruments that address general clinical situations rather than those specific to end-of-life care. Furthermore, qualitative studies have often been limited to participants from a single unit or those experiencing moral distress-induced circumstances. A comprehensive and integrated understanding of the overarching process of moral distress is vital to discern the unique circumstances surrounding (...)
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  • Instruments of Moral Distress: An Analysis Based on Scientificity and Application Value.Lijun Shen, Hui Zhang, Yongguang Yang, Shixiu Liao & Yuming Wang - 2023 - American Journal of Bioethics 23 (4):89-91.
    In the target article by Kolbe and de Melo-Martin (2023), the authors discussed several shortcomings of major instruments of moral distress, including the Moral Distress Scale (MDS) (Corley et al....
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  • COVID-19 guidelines and media influenced ethical care in nursing homes.Caroline Wachtler, Monica Bergqvist, Pia Bastholm-Rahmner, Lars L. Gustafsson & Katharina Schmidt-Mende - forthcoming - Nursing Ethics.
    Background The early phase of the COVID-19 pandemic affected nursing homes and their residents heavily. Guidelines on how to mitigate the virus’s spread and ensuring safe healthcare delivery were continually evolving. Concurrently, nursing homes faced intense media scrutiny. This challenging environment severely impacted registered nurses and physicians employed within these facilities. Aim To understand the ethical challenges experienced by registered nurses and physicians working in nursing homes during the COVID-19 pandemic. Research design Qualitative descriptive research using thematic analysis. Participants and (...)
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  • Moral Distress and the Marginalization of Nurses.Georgina Campelia & Carina Fourie - 2024 - American Journal of Bioethics 24 (1):132-134.
    Responding to the nurse’s moral distress in this case depends on a deeper understanding of the source. It is possible that there is concern that resuscitation is morally wrong—perhaps because it wo...
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  • “Please, Don’t Make Me Do This”: The Role of the Ethics Consultant in Responding to and Mitigating Moral Distress.Georgina Morley & Steven Bocchese - 2024 - American Journal of Bioethics 24 (1):134-137.
    In response to the case study of Mr. Rivers, we will speak to three critical elements for an ethics consultant to address when a consult is requested due to moral distress. First, discern if the re...
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  • Ethics Debriefs and Moral Distress: What are we Doing?A. Lee de Bie, Steve Abdool, Jeremy Butler, Alexandra Campbell, Maram Hassanein, Sean Hillman, Juhee Makkar, Rochelle Maurice, Jamie Robertson, Michael J. Szego & Dave Langlois - 2023 - American Journal of Bioethics 23 (4):74-77.
    Our team at the Centre for Clinical Ethics has long been engaged in internal discussion about the purpose and value of ethics debriefs and their purported role in reducing moral distress (Morley an...
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  • Measure for Measure: Condemning the Actor and Not the Fault.Elizabeth G. Epstein, Ashley R. Hurst, Dawn Bourne & Mary Faith Marshall - 2023 - American Journal of Bioethics 23 (4):66-68.
    Kolbe and de Melo-Martin’s (2023) arguments draw attention to what is most useful about moral distress—identifying its causes is at least as important as measuring its severity. Jameton’s original...
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  • Capturing Moral Distress as a Global Phenomenon in Healthcare.Heidi Matisonn, Jantina de Vries & Jackie Hoare - 2023 - American Journal of Bioethics 23 (4):82-84.
    Whilst Kolbe and de Melo-Martin (2023) appropriately identify a range of concerns about the validity of existing instruments to measure moral distress, one additional limitation that the authors di...
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  • Re‐examining the relationship between moral distress and moral agency in nursing.Georgina Morley & Lauren R. Sankary - 2024 - Nursing Philosophy 25 (1):e12419.
    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 (...)
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  • Evolving Measures of Moral Distress: Imperfect Does Not Mean Irrelevant.Lucia D. Wocial - 2023 - American Journal of Bioethics 23 (4):68-71.
    The article “Moral distress: What are we measuring?” by Kolbe and de Melo-Martin (2023) is an important contribution both to the literature and research agenda for the complicated construct of mora...
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  • Moral Distress Is a Systemic Problem Requiring Organizational Solutions.Timothy Usset & Sophia Fantus - 2023 - American Journal of Bioethics 23 (4):84-86.
    Laura Kolbe and Inmaculada de Melo-Martin (2023) give perspective on the challenge of measuring and defining the concept of moral distress (MD). Limitations in psychometric instruments are a consta...
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  • You Say Potato, I Say Potahto: Should We Call the Whole Thing Off?Connie M. Ulrich, Anessa Foxwell, Christine Grady, Georgina Morley & Carol Taylor - 2024 - American Journal of Bioethics 24 (12):26-28.
    It is no secret that there are problems within hospitals and other healthcare settings across the United States that have been simmering for some time. With the emergence of the deadly SARs-CoV-2 v...
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  • Measuring Moral Distress and its Various Sources.Connie M. Ulrich & Christine Grady - 2023 - American Journal of Bioethics 23 (4):63-65.
    Moral distress is indeed distressing for those who experience it and whose sense of integrity can be shaken by exposure to events or situations that test their core values and ethical belief system...
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  • Moral Distress Tools: Not Just a Question of What but Why Are We Measuring?Trisha M. Prentice - 2023 - American Journal of Bioethics 23 (4):59-61.
    All research tools have limitations. Not all tools will be suited to every purpose. Understanding the limitations and accurately interpreting the output from any tool is essential to conducting mea...
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  • Sub-categories of moral distress among nurses: A descriptive longitudinal study.Georgina Morley, James F. Bena, Shannon L. Morrison & Nancy M. Albert - 2023 - Nursing Ethics 30 (6):885-903.
    Background There is ongoing debate regarding how moral distress should be defined. Some scholars argue that the standard “narrow” definition overlooks morally relevant causes of distress, while others argue that broadening the definition of moral distress risks making measurement impractical. However, without measurement, the true extent of moral distress remains unknown. Research aims To explore the frequency and intensity of five sub-categorizations of moral distress, resources used, intention to leave, and turnover of nurses using a new survey instrument. Research design (...)
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  • Moral Distress and Justifiable Constraints on Moral Agency.Georgina Morley & Lauren R. Sankary - 2023 - American Journal of Bioethics 23 (4):77-79.
    While Jameton’s (1984) definition of moral distress has been embraced by researchers and scholars for recognizing the many constraints that nurses experience on their moral agency, it has also been...
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  • Moral Distress: The Context of Measurement.Niek Kok, Marieke Zegers, Cornelia Hoedemaekers & Jelle van Gurp - 2023 - American Journal of Bioethics 23 (4):71-74.
    Kolbe and de Melo-Martin (2023) provide a much needed reflection on the methods by which we measure moral distress. Their analysis, however, gives off the impression that the measures of moral dist...
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  • Clinician Moral Distress: Toward an Ethics of Agent‐Regret.Daniel T. Kim, Wayne Shelton & Megan K. Applewhite - 2023 - Hastings Center Report 53 (6):40-53.
    Moral distress names a widely discussed and concerning clinician experience. Yet the precise nature of the distress and the appropriate practical response to it remain unclear. Clinicians speak of their moral distress in terms of guilt, regret, anger, or other distressing emotions, and they often invoke them interchangeably. But these emotions are distinct, and they are not all equally fitting in the same circumstances. This indicates a problematic ambiguity in the moral distress concept that obscures its distinctiveness, its relevant circumstances, (...)
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  • Moral Distress as Critique: Going beyond ‘Illegitimate Institutional Constraints’.Kate Jackson-Meyer, Xavier Symons & Charlotte Duffee - 2023 - American Journal of Bioethics 23 (4):79-82.
    Kolbe and de Melo-Martin (2023) raise important concerns about the limited usefulness of measures of moral distress. They propose that moral distress is best measured in terms of “illegitimate inst...
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  • Measuring Moral Distress: Improving the Tools by Educating Clinicians.Lauren Boxell & Elizabeth Lanphier - 2023 - American Journal of Bioethics 23 (4):61-63.
    In “Moral Distress: What are we measuring?” Kolbe and de Melo-Martin (2023) rightly note that varied understanding of moral distress, paired with shortcomings in existing empirical tools to accurat...
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  • Moral Distress in Military Medicine: Toward Analysis of, and Approach to Measurement, Prevention and Care.Megan Applewhite & James Giordano - 2023 - American Journal of Bioethics 23 (4):86-88.
    Kolbe and de Melo-Martin (2023) describe fatal problems in current definitions and measurement of moral distress and injury (MD/I) in medical professionals, which impede development of genuine atte...
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