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Moral Distress (moral + distress)

Distribution by Scientific Domains

Medical Sciences	88%

Selected Abstracts

Ethical Dilemma and Moral Distress: Proposed New NANDA Diagnoses

INTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 1 2005
Beverly Kopala
purpose., To propose two NANDA diagnoses,ethical dilemma and moral distress,and to distinguish between the NANDA diagnosis decisional conflict and the proposed nursing diagnosis of ethical dilemma. sources used., Journal articles, books, and focus group research findings. data synthesis., Moral/ethical situations exist in health care. Nurses' experiences of ethical dilemmas and moral distress are extrapolated to the types and categories of ethical dilemmas and moral distress that patients experience and are used as the basis for development of two new nursing diagnoses. conclusion., The two proposed NANDA diagnoses fill a void in current standardized terminology. practice implications., It is important that nurses have the ability to diagnose ethical or moral situations in health care. Currently, NANDA does not offer a means to document this important phenomenon. The creation of two sets of nursing diagnoses, ethical dilemma and moral distress, will enable nurses to recognize and track nursing care related to ethical or moral situations. [source]

Organ Sales and Moral Distress

JOURNAL OF APPLIED PHILOSOPHY, Issue 1 2006
EDUARDO RIVERA-LÓPEZ
abstract The possibility that organ sales by living adults might be made legal is morally distressing to many of us. However, powerful arguments have been provided recently supporting legalisation (I consider two of those arguments: the Consequentialist Argument and the Autonomy Argument). Is our instinctive reaction against a market of organs irrational then? The aim of this paper is not to prove that legalization would be immoral, all things considered, but rather to show, first, that there are some kinds of arguments, offered in favour of legalisation, that are, in an important sense, illegitimate, and second, that even if legalisation might not be wrong all things considered, there are good reasons for our negative moral intuitions. Moreover, identifying these reasons will help highlight some features of moral decisions in non-ideal situations, which in turn might be relevant to some other moral or policy choices. [source]

Whose life is it anyway?

INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 4 2008
An exploration of five contemporary ethical issues that pertain to the psychiatric nursing care of the person who is suicidal: Part one
ABSTRACT:, It is self-evident that ethical issues are important topics for consideration for those involved in the care of the person who is suicidal. Nevertheless, despite the obvious relationship between Mental Health nurses and care of the person who is suicidal, such nurses have hitherto been mostly silent on these matters. As a result, this two-part paper focuses on a number of contemporary issues which might help inform the ethical discourse and resultant Mental Health nursing care of the person who is suicidal. Part one of this paper focuses on the issues: Whose life is it anyway? Harming of our bodies and the inconsistency in ethical responses and, Is suicide ever a reasonable thing to do? The authors find that this contemporary view within the suicidology academe and the corresponding legal position in most western (developed) countries is that the individual owns his/her own body. Yet given that contemporary mental healthcare policy and associated practice positions do not reflect view, this can easily lead to the scenario where a Mental Health nurse is faced with a major ethical dilemma, and the corresponding probability of moral distress. The authors also find that it is inaccurate to posit a simple positive correlation between the potential seriousness and/or extent of bodily harm and the degree of paternalistic removal of an individual's rights to personal body ownership. Lastly, the authors find that the relevant theoretical and ethical literature in this area suggests, at least for some and under certain conditions, suicide can be the right thing to do. [source]

Ethical Dilemma and Moral Distress: Proposed New NANDA Diagnoses

Nurses' Narratives of Unforgettable Patient Care Events

JOURNAL OF NURSING SCHOLARSHIP, Issue 4 2006
Mary Gunther
Purpose: To explore the experience of registered nurses (RNs) caring for patients in contemporary hospitals. Design: The descriptive phenomenological study was based in the philosophical perspectives of Husserl and Merleau-Ponty. Methods: A purposive sample of 46 RNs employed in acute care hospitals in the southeastern United States (US) were recruited by network sampling. Data from unstructured interviews were analyzed in an interpretive group and themes were identified. Findings: Four themes were identified: (a) extraordinary caregiving events, (b) incomprehensibility, (c) questioning whether anything else could have been done, and (d) "alone or together," indicating the isolation nurses often experience while giving care as well as profound moments of connection, especially with patients. Conclusions: Caregiving experiences resulted in an accumulating residue of moral distress which in turn became ground for future experiences in the everyday work life of RNs. Sometimes years later, participants were still trying to justify and understand the outcomes and perhaps to absolve themselves from blame. Participants were confronted with the limits of science and skill and plunged into the realm of existential questions for which they had no ready answers. [source]

Understanding and Responding to Patients' Requests for Assistance in Dying

JOURNAL OF NURSING SCHOLARSHIP, Issue 4 2003
Judith Kennedy Schwarz
Purpose: To explore how nurses experience and respond to patients' requests for assistance in dying (AID). Design and Methods: A phenomenological study of 10 self-selected nurses. Findings: Four major themes: Being Open to Hear and Hearing; Interpreting and Responding to the Meaning; Responding to Persistent Requests for AID, and Reflections. When faced with persistent requests for AID, participants provided a continuum of interventions: refusal, providing palliative care that might secondarily hasten dying, respecting and not interfering with patients' or families' plans to hasten dying, and providing varying types and degrees of direct AID. Their responses were context-driven rather than rule-mandated, and they drew a distinction between secondarily hastening and directly causing death. Conclusions: Few nurses in this study unequivocally agreed or refused to directly help a patient die. Most struggled alone and in silence to find a morally and legally acceptable way to help patients who persisted in requesting AID. Regardless of how they responded, many described feelings of conflict, guilt, and moral distress. [source]

Perils of proximity: a spatiotemporal analysis of moral distress and moral ambiguity

NURSING INQUIRY, Issue 4 2004
Elizabeth Peter
The physical nearness, or proximity, inherent in the nurse,patient relationship has been central in the discipline as definitive of the nature of nursing and its moral ideals. Clearly, this nearness is in service to those in need of care. This proximity, however, is not unproblematic because it contributes to two of the most prolonged difficulties, both for individual nurses and the discipline of nursing , moral distress and moral ambiguity. In this paper we explore proximity using both a moral and geographical lens and offer some insights regarding this practice reality. We examine the effect of proximity to patients on nurses' moral responsiveness, particularly as it affects nurses' moral distress. Proximity is paradoxical in this regard because, while it propels nurses to act, it can also propel nurses to ignore or abandon. Likewise, we argue that nursing's tendency to define itself in relation to the closeness of the nurse,patient relationship leads to problems of moral ambiguity. Our recommendations include moving others closer to the bedside and thus to the work of nursing in the literal and theoretical sense. [source]