Abstract
While various definitions of moral distress have been proposed, some agreement exists that
it results from illegitimate constraints in clinical practice affecting healthcare professionals’
moral agency. If we are to reduce moral distress, instruments measuring it should provide
relevant information about such illegitimate constraints. Unfortunately, existing instruments
fail to do so. We discuss here several shortcomings of major instruments in use: their
inability to determine whether reports of moral distress involve an accurate assessment of
the requisite clinical and logistical facts in play, whether the distress in question is aptly
characterized as moral, and whether the moral distress reported is an appropriate target of
elimination. Such failures seriously limit the ability of empirical work on moral distress to
foster appropriate change.