Journal
AMERICAN JOURNAL OF BIOETHICS
Volume 23, Issue 4, Pages 46-58Publisher
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
DOI: 10.1080/15265161.2022.2044544
Keywords
Moral distress; moral agency; empirical bioethics; clinical practice
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This article discusses the shortcomings of existing instruments for measuring moral distress, including the inability to determine whether reports of moral distress accurately assess the relevant facts, whether the distress is appropriately characterized as moral, and whether the reported moral distress is an appropriate target for elimination. These failures seriously limit the ability of empirical research on moral distress to promote appropriate change.
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.
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