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  1. Moral Hazard Analysis: Illuminating the Moral Contribution of Important Stakeholders.Lucia D. Wocial - 2016 - American Journal of Bioethics 16 (7):48-50.
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  • Organizational Influences on Health Professionals’ Experiences of Moral Distress in PICUs.Sarah Wall, Wendy J. Austin & Daniel Garros - 2016 - HEC Forum 28 (1):53-67.
    This article reports the findings of a qualitative study that explored the organizational influences on moral distress for health professionals working in pediatric intensive care units across Canada. Participants were recruited to the study from PICUs across Canada. The PICU is a high-tech, fast-paced, high-pressure environment where caregivers frequently face conflict and ethical tension in the care of critically ill children. A number of themes including relationships with management, organizational structure and processes, workload and resources, and team dynamics were identified. (...)
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  • A Philosophical Taxonomy of Ethically Significant Moral Distress: Figure 1.Tessy A. Thomas & Laurence B. McCullough - 2015 - Journal of Medicine and Philosophy 40 (1):102-120.
    Moral distress is one of the core topics of clinical ethics. Although there is a large and growing empirical literature on the psychological aspects of moral distress, scholars, and empirical investigators of moral distress have recently called for greater conceptual clarity. To meet this recognized need, we provide a philosophical taxonomy of the categories of what we call ethically significant moral distress: the judgment that one is not able, to differing degrees, to act on one’s moral knowledge about what one (...)
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  • Take Me to My Leader.Janet Storch, Kara Schick Makaroff, Bernie Pauly & Lorelei Newton - 2013 - Nursing Ethics 20 (2):150-157.
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  • Identification of Risk Factors for Moral Distress in Nurses: Basis for the Development of a New Assessment Tool.Rafaela Schaefer, Elma Lourdes Campos Pavone Zoboli & Margarida Vieira - 2016 - Nursing Inquiry 23 (4):346-357.
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  • Moral Distress in Undergraduate Nursing Students.Loredana Sasso, Annamaria Bagnasco, Monica Bianchi, Valentina Bressan & Franco Carnevale - 2016 - Nursing Ethics 23 (5):523-534.
    Background:Nurses and nursing students appear vulnerable to moral distress when faced with ethical dilemmas or decision-making in clinical practice. As a result, they may experience professional dissatisfaction and their relationships with patients, families, and colleagues may be compromised. The impact of moral distress may manifest as anger, feelings of guilt and frustration, a desire to give up the profession, loss of self-esteem, depression, and anxiety.Objectives:The purpose of this review was to describe how dilemmas and environmental, relational, and organizational factors contribute (...)
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  • Re-Defining Moral Distress: A Systematic Review and Critical Re-Appraisal of the Argument-Based Bioethics Literature.Christine Sanderson, Linda Sheahan, Slavica Kochovska, Tim Luckett, Deborah Parker, Phyllis Butow & Meera Agar - 2019 - Clinical Ethics 14 (4):195-210.
    The concept of moral distress comes from nursing ethics, and was initially defined as ‘…when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action’. There is a large body of literature associated with moral distress, yet multiple definitions now exist, significantly limiting its usefulness. We undertook a systematic review of the argument-based bioethics literature on this topic as the basis for a critical appraisal, identifying 55 papers for analysis. (...)
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  • Seeing Ourselves as Moral Agents in Relation to Our Organizational and Sociopolitical Contexts: Commentary on “A Reflection on Moral Distress in Nursing Together With a Current Application of the Concept” by Andrew Jameton.Patricia A. Rodney - 2013 - Journal of Bioethical Inquiry 10 (3):313-315.
  • Can the Ethical Best Practice of Shared Decision-Making Lead to Moral Distress?Trisha M. Prentice & Lynn Gillam - 2018 - Journal of Bioethical Inquiry 15 (2):259-268.
    When healthcare professionals feel constrained from acting in a patient’s best interests, moral distress ensues. The resulting negative sequelae of burnout, poor retention rates, and ultimately poor patient care are well recognized across healthcare providers. Yet an appreciation of how particular disciplines, including physicians, come to be “constrained” in their actions is still lacking. This paper will examine how the application of shared decision-making may contribute to the experience of moral distress for physicians and why such distress may go under-recognized. (...)
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  • Moral Distress Reexamined: A Feminist Interpretation of Nurses' Identities, Relationships, and Responsibilites. [REVIEW]Elizabeth Peter & Joan Liaschenko - 2013 - Journal of Bioethical Inquiry 10 (3):337-345.
    Moral distress has been written about extensively in nursing and other fields. Often, however, it has not been used with much theoretical depth. This paper focuses on theorizing moral distress using feminist ethics, particularly the work of Margaret Urban Walker and Hilde Lindemann. Incorporating empirical findings, we argue that moral distress is the response to constraints experienced by nurses to their moral identities, responsibilities, and relationships. We recommend that health professionals get assistance in accounting for and communicating their values and (...)
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  • Advancing the Concept of Moral Distress.Elizabeth Peter - 2013 - Journal of Bioethical Inquiry 10 (3):293-295.
  • Making the Call: A Proactive Ethics Framework. [REVIEW]Carol Pavlish, Katherine Brown-Saltzman, Alyssa Fine & Patricia Jakel - 2013 - HEC Forum 25 (3):269-283.
    This manuscript proposes a proactive framework for preventing or mitigating disruptive ethical conflicts that often result from delayed or avoided conversations about the ethics of care. Four components of the framework are explained and illustrated with evidenced-based actions. Clinical implications of adopting a prevention-based, system-wide ethics framework are discussed. While some aspects of ethically-difficult situations are unique, system patterns allow some issues to occur repeatedly—often with lingering effects such as healthcare providers’ disengagement and moral distress (McAndrew et al. Journal of (...)
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  • Moral Distress Experienced by Nurses: A Quantitative Literature Review.Younjae Oh & Chris Gastmans - 2015 - Nursing Ethics 22 (1):15-31.
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  • The Normative and Evaluative Status of Moral Distress in Health Care Contexts.Sven Nyholm - 2016 - American Journal of Bioethics 16 (12):17-19.
    Stephen Campbell, Connie Ulrich, and Christine Grady argue that we need to a broader understanding of moral distress – broader, that is, than the one commonly used within nursing-ethics and, more recently, healthcare ethics in general. On their proposed definition, moral distress is any self-directed negative attitude we might have in response to viewing ourselves as participating in a morally undesirable situation. While being in general agreement with much of what Campbell et al. say, I make two suggestions. First, in (...)
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  • Moving From Conceptual Ambiguity to Knowledgeable Action: Using a Critical Realist Approach to Studying Moral Distress.Lynn C. Musto & Patricia A. Rodney - 2016 - Nursing Philosophy 17 (2):75-87.
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  • Moral Distress Situations in Nursing Care.Mozhgan Moshtagh & Mohaddeseh Mohsenpour - 2019 - Clinical Ethics 14 (3):141-145.
    IntroductionWhen professional nurses face an obstacle in their perfect purposes, they would experience moral distress which is a suffering situation. This study aims at exploring conditions which lead to high levels of moral distress for nursing personnel within a teaching hospital in Iran.MethodsAll nursing staffs worked in ICU, CCU, open heart surgery and emergency ward of a teaching hospital in Mashhad, Iran, were evaluated in a descriptive study by translated and modified moral distress questionnaire of Corley.ResultsAccording to the participants, the (...)
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  • Nurse Ethical Awareness: Understanding the Nature of Everyday Practice.Aimee Milliken & Pamela Grace - 2017 - Nursing Ethics 24 (5):517-524.
  • The Standard Account of Moral Distress and Why We Should Keep It.Joan McCarthy & Settimio Monteverde - 2018 - HEC Forum 30 (4):319-328.
    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 (...)
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  • Phronesis of Nurses: A Response to Moral Distress.Hsun-Kuei Ko, Hui-Chen Tseng, Chi-Chun Chin & Min-Tao Hsu - forthcoming - Nursing Ethics:096973301983312.
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  • Moral Distress: What Are We Measuring?Laura Kolbe & Inmaculada de Melo-Martin - forthcoming - American Journal of Bioethics:1-13.
    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 (...)
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  • Nurses' Perception of Ethical Climate, Medical Error Experience and Intent-to-Leave.J. -I. Hwang & H. -A. Park - 2014 - Nursing Ethics 21 (1):28-42.
  • Conscientious Objection and Moral Distress: A Relational Ethics Case Study of MAiD in Canada.Mary Kathleen Deutscher Heilman & Tracy J. Trothen - 2020 - Journal of Medical Ethics 46 (2):123-127.
    Conscientious objection has become a divisive topic in recent bioethics publications. Discussion has tended to frame the issue in terms of the rights of the healthcare professional versus the rights of the patient. However, a rights-based approach neglects the relational nature of conscience, and the impact that violating one’s conscience has on the care one provides. Using medical assistance in dying as a case study, we suggest that what has been lacking in the discussion of conscientious objection thus far is (...)
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  • Conscientious objection and moral distress: a relational ethics case study of MAiD in Canada.Mary Kathleen Deutscher Heilman & Tracy J. Trothen - 2020 - Journal of Medical Ethics Recent Issues 46 (2):123-127.
    Conscientious objection has become a divisive topic in recent bioethics publications. Discussion has tended to frame the issue in terms of the rights of the healthcare professional versus the rights of the patient. However, a rights-based approach neglects the relational nature of conscience, and the impact that violating one’s conscience has on the care one provides. Using medical assistance in dying as a case study, we suggest that what has been lacking in the discussion of conscientious objection thus far is (...)
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  • Les Enjeux Éthiques En Réadaptation. Un État des Lieux de la Conceptualisation de Notions Éthiques.Marie Goulet & Marie-Josée Drolet - 2018 - Canadian Journal of Bioethics/Revue canadienne de bioéthique 1 (3):9-21.
    In rehabilitation, there is a growing interest in ethics. That said, few meta-ethical reflections have been conducted to date. Therefore, a review and critical analysis of the use of the concept of “ethical issue” is warranted. To this end, a systematic and critical review of the literature discussing ethical issues in rehabilitation was conducted. This review, based on the method developed by McCullough and colleagues, identified and analyzed 80 articles. Several characteristics and gaps in the conceptualization of the ethical issue (...)
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  • Hazard Warning! The Perils of Extending Moral Hazard Analysis Only to Contrarian Parents.Michael R. Gomez, Rebecca Moran, Ricky T. Munoz & Mark D. Fox - 2016 - American Journal of Bioethics 16 (7):50-52.
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  • Beyond Technology, Drips, and Machines: Moral Distress in PICU Nurses Caring for End‐of‐Life Patients.Michelle Gagnon & Diane Kunyk - 2022 - Nursing Inquiry 29 (2).
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  • Interprofessional Collaboration-in-Practice: The Contested Place of Ethics.C. Ewashen, G. McInnis-Perry & N. Murphy - 2013 - Nursing Ethics (3):0969733012462048.
    The main question examined is: How do nurses and other healthcare professionals ensure ethical interprofessional collaboration-in-practice as an everyday practice actuality? Ethical interprofessional collaboration becomes especially relevant and necessary when interprofessional practice decisions are contested. To illustrate, two healthcare scenarios are analyzed through three ethics lenses. Biomedical ethics, relational ethics, and virtue ethics provide different ways of knowing how to be ethical and to act ethically as healthcare professionals. Biomedical ethics focuses on situated, reflective, and nonabsolute principled justification, all things (...)
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  • Is Broader Better?Elizabeth G. Epstein, Ashley R. Hurst, Dea Mahanes, Mary Faith Marshall & Ann B. Hamric - 2016 - American Journal of Bioethics 16 (12):15-17.
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  • Enhancing Understanding of Moral Distress: The Measure of Moral Distress for Health Care Professionals.Elizabeth G. Epstein, Phyllis B. Whitehead, Chuleeporn Prompahakul, Leroy R. Thacker & Ann B. Hamric - 2019 - AJOB Empirical Bioethics 10 (2):113-124.
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  • Christian Bioethics and the Partisan Commitments of Secular Bioethicists: Epistemic Injustice, Moral Distress, Civil Disobedience.Mark J. Cherry - 2021 - Christian Bioethics 27 (2):123-139.
    Secular bioethicists do not speak from a place of distinction, but from within particular culturally, socially, and historically conditioned standpoints. As partisans of moral and ideological agendas, they bring their own biases, prejudices, and worldviews to their roles as ethical consultants, social advocates, and academics, attempting rhetorically to sway others and shift policy to a preferred point of view. Their pronouncements represent just one voice among others, even when delivered with strident rhetoric, in an educated and knowing tone, from within (...)
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  • Moral Hazard in Pediatrics.Donald Brunnquell & Christopher M. Michaelson - 2016 - American Journal of Bioethics 16 (7):29-38.
    “Moral hazard” is a term familiar in economics and business ethics that illuminates why rational parties sometimes choose decisions with bad moral outcomes without necessarily intending to behave selfishly or immorally. The term is not generally used in medical ethics. Decision makers such as parents and physicians generally do not use the concept or the word in evaluating ethical dilemmas. They may not even be aware of the precise nature of the moral hazard problem they are experiencing, beyond a general (...)
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  • Moral Distress Interventions: An Integrative Literature Review.Vanessa K. Amos & Elizabeth Epstein - 2022 - Nursing Ethics 29 (3):582-607.
    Moral distress has been well reviewed in the literature with established deleterious side effects for all healthcare professionals, including nurses, physicians, and others. Yet, little is known about the quality and effectiveness of interventions directed to address moral distress. The aim of this integrative review is to analyze published intervention studies to determine their efficacy and applicability across hospital settings. Of the initial 1373 articles discovered in October 2020, 18 were appraised as relevant, with 1 study added by hand search (...)
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