Tiedje L B
Department of Epidemiology, Michigan State University, East Lansing, Michigan, USA.
J Perinat Neonatal Nurs. 2000 Sep;14(2):36-43. doi: 10.1097/00005237-200009000-00005.
This work focuses on an emerging concept in nursing ethics--moral distress. Unlike an ethical dilemma where one does not know the right thing to do, in contrast, moral distress occurs when one knows the right thing to do but is constrained by the institution or one's coworkers in doing it. Moral distress is a process that involves recognition that a decision is difficult to act upon; the experience of emotional distress inherent in that situation; choosing strategies; and then acting. Whistle blowing and collaborative practice models both provide strategies for moral action in moral distress situations. Less dramatic and quieter forms of moral action will also be examined. Finally, developing the strength to move from moral distress to moral action will be discussed, as well as research implications for this emerging ethical issue.
这项工作聚焦于护理伦理学中一个新兴的概念——道德困扰。与不知该如何做正确之事的伦理困境不同，道德困扰发生在一个人知道正确之事却受到机构或同事限制而无法去做的时候。道德困扰是一个过程，包括认识到一个决定难以付诸行动；在那种情况下内在的情绪困扰体验；选择策略；然后采取行动。揭发检举和协作实践模式都为道德困扰情形下的道德行动提供了策略。也将审视不那么引人注意和较为平和的道德行动形式。最后，将讨论培养从道德困扰转向道德行动的力量，以及针对这个新兴伦理问题的研究意义。
