Medicine, Health Care and Philosophy 23 (2):165-177 (2020)

Lisa Tessman
State University of New York at Binghamton
Nurses and other medical practitioners often experience moral distress: they feel an anguished sense of responsibility for what they take to be their own moral failures, even when those failures were unavoidable. However, in such cases other people do not tend to think it is right to hold them responsible. This is an interesting mismatch of reactions. It might seem that the mismatch should be remedied by assuring the practitioner that they are not responsible, but I argue that this denies something important that the phenomenon of moral distress tells us. In fact, both the practitioners’ tendencies to hold themselves responsible and other people’s reluctance to hold the practitioners responsible get something right. The practitioners may be right that they are responsible in the sense of having failed to meet a binding moral requirement, even when the requirement was impossible to meet. This makes moral distress a fitting response because it correctly represents their own action as a wrongdoing. However, others may meanwhile be right that the practitioners are not responsible in the sense of being culpable and blameworthy. To blame others, or oneself, for certain failures, including those that are unavoidable, would be unfair. My claim depends on distinguishing between the fittingness and the fairness of holding someone responsible for moral failure. Having drawn the distinction, I suggest that moral distress should be addressed in a way that both recognizes it as a fitting response and avoids the unfairness of blame.
Keywords moral distress  medical ethics  nursing ethics  reactive attitudes  moral responsibility  moral failure  fittingness  wrong kind of reason  blame  moral dilemma
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DOI 10.1007/s11019-020-09942-7
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References found in this work BETA

Freedom and Resentment.Peter Strawson - 1962 - Proceedings of the British Academy 48:187-211.
Responsibility From the Margins.David Shoemaker - 2015 - Oxford University Press.

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Citations of this work BETA

Moral Distress: What Are We Measuring?Laura Kolbe & Inmaculada de Melo-Martin - forthcoming - American Journal of Bioethics:1-13.

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