McCarthy Joan, Deady Rick
School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, Republic of Ireland.
Nurs Ethics. 2008 Mar;15(2):254-62. doi: 10.1177/0969733007086023.
Moral distress has received much attention in the international nursing literature in recent years. In this article, we describe the evolution of the concept of moral distress among nursing theorists from its initial delineation by the philosopher Jameton to its subsequent deployment as an umbrella concept describing the impact of moral constraints on health professionals and the patients for whom they care. The article raises worries about the way in which the concept of moral distress has been portrayed in some nursing research and expresses concern about the fact that research, so far, has been largely confined to determining the prevalence of experiences of moral distress among nurses. We conclude by proposing a reconsideration, possible reconstruction and multidisciplinary approach to understanding the experiences of all health professionals who have to make difficult moral judgements and decisions in complex situations.
近年来,道德困扰在国际护理文献中受到了广泛关注。在本文中,我们描述了护理理论家们对道德困扰概念的认识演变,从哲学家杰米顿最初对其的界定,到后来将其作为一个总括性概念,用以描述道德约束对医疗专业人员及其所护理患者的影响。本文对道德困扰概念在一些护理研究中的呈现方式提出了担忧,并对以下事实表示关注:迄今为止,研究主要局限于确定护士群体中道德困扰经历的发生率。我们在结论中建议重新审视、可能进行重构,并采用多学科方法来理解所有在复杂情况下必须做出艰难道德判断和决策的医疗专业人员的经历。