Center for Bioethics, Cleveland Clinic, USA.
School of Nursing, University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland.
Bioethics. 2021 Jan;35(1):61-71. doi: 10.1111/bioe.12783. Epub 2020 Jul 12.
There has been increasing debate in recent years about the conceptualization of moral distress. Broadly speaking, two groups of scholars have emerged: those who agree with Jameton's 'narrow definition' that focuses on constraint and those who argue that Jameton's definition is insufficient and needs to be broadened. Using feminist empirical bioethics, we interviewed critical care nurses in the United Kingdom about their experiences and conceptualizations of moral distress. We provide our broader definition of moral distress and examples of data that both challenge and support our conceptualization. We pre-empt and overcome three key challenges that could be levelled at our account and argue that there are good reasons to adopt our broader definition of moral distress when exploring prevalence of, and management strategies for, moral distress.
近年来,关于道德困境的概念化问题一直存在争议。广义而言,出现了两类学者:一类赞同杰梅顿的“狭义定义”,即关注约束;另一类则认为杰梅顿的定义不够充分,需要加以扩展。本研究采用女性主义经验生命伦理学,对英国重症监护护士进行了有关道德困境的经历和概念化的访谈。我们提供了道德困境的更广泛定义,并举例说明了挑战和支持我们概念化的相关数据。我们预先应对并克服了可能针对我们观点提出的三个关键挑战,并认为在探讨道德困境的普遍性和管理策略时,采用我们对道德困境的更广泛定义是有充分理由的。