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

Details

• Personal Author:
  Berlinger N ; Brown A ; Buchbinder L ; Buchbinder M ; Jenkins T
• 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 moral distress, moral injury, and moral stress 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. [Description provided by NIOSH]
• Subjects:
  Communicable Diseases Health Personnel Occupational Health Safety Stress, Psychological
• Keywords:
  Author Keywords: Agency COVID-19 Ethics Health Care Job Stress Moral Distress Moral Stress Physicians Professional Integrity Professional Wellbeing Wellbeing

  More +
• ISSN:
  1526-5161
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Atlanta Region [OSHA] ; California ; New York ; New York City Region [OSHA] ; North Carolina ; San Francisco Region [OSHA]
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  8-22
• Volume:
  24
• Issue:
  12
• NIOSHTIC Number:
  nn:20069009
• Citation:
  Am J Bioeth 2024 Dec; 24(12):8-22
• Contact Point Address:
  Mara Buchbinder, 333 S. Columbia Street, 341A MacNider CB 7240, Chapel Hill, NC 27599, USA
• Email:
  mara_buchbinder@med.unc.edu
• Federal Fiscal Year:
  2025
• Performing Organization:
  University of North Carolina Chapel Hill
• Peer Reviewed:
  True
• Start Date:
  20210901
• Source Full Name:
  The American Journal of Bioethics
• End Date:
  20230831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:763a61e5a965ea6964b8a0501f147e980928175b157d11a814f74cb2a9bf59a508874d2ea5444730690f04ac4f872cd2510cf4d616599631cf6a2ecb55b75e8e
• Download URL:
  https://stacks.cdc.gov/view/cdc/207565/cdc_207565_DS1.pdf
• File Type:
  [PDF - 1.56 MB ]