Moral Stress and Moral Distress: Confronting Challenges in Healthcare Systems Under Pressure

Details

• Alternative Title:
  Am J Bioeth
• Personal Author:
  Buchbinder, Mara ; Browne, Alyssa ; Berlinger, Nancy ; Jenkins, Tania ; Buchbinder, Liza
• Description:
  Stresses on healthcare systems and moral distress among clinicians are urgent, intertwined bioethical problems in contemporary healthcare. Yet conceptualizations of moral distress in bioethical inquiry often overlook a range of routine threats to professional integrity in healthcare work. Using examples from our research on frontline physicians working during the COVID-19 pandemic, this article clarifies conceptual distinctions between |, |, and | and illustrates how these concepts operate together in healthcare work. Drawing from the philosophy of healthcare, we explain how moral stress results from the normal operations of overstressed systems; unlike moral distress and moral injury, it may not involve a sense of powerlessness concerning patient care. The analysis of moral stress directs attention beyond the individual, to stress-generating systemic factors. We conclude by reflecting on how and why this conceptual clarity matters for improving clinicians' professional wellbeing, and offer preliminary pathways for intervention.
• Subjects:
  COVID-19 Delivery Of Health Care Health Personnel Humans Morals Pandemics Physicians SARS-CoV-2 Stress, Psychological
• Keywords:
  Agency Moral Distress Moral Stress Professional Integrity Professional Wellbeing
• Source:
  Am J Bioeth. 24(12):8-22
• Pubmed ID:
  37347222
• Pubmed Central ID:
  PMC10758677
• Document Type:
  Journal Article
• Funding:
  R21 OH012175/OH/NIOSH CDC HHSUnited States/
• Volume:
  24
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:8ca898d5fb5e3b9daa31d5a5475f33235acf616ae20088ffec9af45ed52e7c254557608ceabdcfc6109e8c74699c3c1c871b6e3877f836fed82b7fa5eb2cbddb
• Download URL:
  https://stacks.cdc.gov/view/cdc/140154/cdc_140154_DS1.pdf
• File Type:
  [PDF - 116.90 KB ]