Hanna Debra R
New York-Presbyterian, New York, NY, USA.
Res Theory Nurs Pract. 2004 Spring;18(1):73-93. doi: 10.1891/rtnp.18.1.73.28054.
Moral distress, a complex human experience, has lacked a clear, complete definition. Intuitively, clinicians know that moral distress might be occurring for patients with increasing frequency due to technological advances that alter the natural order of life and death. Yet clinicians have not been able to evaluate the presence or extent of moral distress. To date, moral distress has been investigated mainly as an occupational issue using Jameton's (1984) definition, which has been problematic for several reasons. Without an adequate definition, moral distress can be unrecognized, yet have a silent, clinically significant impact on health. The literature is discussed from several perspectives to show the current state of the science in this topical area, and its potential future.
道德困扰是一种复杂的人类体验，一直缺乏清晰、完整的定义。凭直觉，临床医生知道，由于技术进步改变了生死的自然秩序，道德困扰在患者中出现的频率可能越来越高。然而，临床医生一直无法评估道德困扰的存在或程度。迄今为止，道德困扰主要是根据贾米顿（1984年）的定义作为一个职业问题进行研究的，由于几个原因，这个定义存在问题。如果没有一个恰当的定义，道德困扰可能会不被识别，但却会对健康产生潜移默化且具有临床意义的影响。本文从几个角度对文献进行了探讨，以展示该热门领域的科学现状及其潜在的未来发展。
