Nurse Moral Distress: a proposed theory and research agenda

2002 ◽  
Vol 9 (6) ◽  
pp. 636-650 ◽  
Author(s):  
Mary C Corley
Keyword(s):  
Research Agenda ◽  
Moral Distress ◽  
Right Action ◽  
Moral Residue ◽  
The Right

As professionals, nurses are engaged in a moral endeavour, and thus confront many challenges in making the right decision and taking the right action. When nurses cannot do what they think is right, they experience moral distress that leaves a moral residue. This article proposes a theory of moral distress and a research agenda to develop a better understanding of moral distress, how to prevent it, and, when it cannot be prevented, how to manage it.

scholarly journals Evaluating science communication

2018 ◽  
Vol 116 (16) ◽  
pp. 7670-7675 ◽  
Author(s):  
Baruch Fischhoff
Keyword(s):  
Voter Turnout ◽  
Research Agenda ◽  
Science Communication ◽  
Systems Approach ◽  
National Research Council ◽  
Decision Makers ◽  
Vaccination Rates ◽  
Communication Processes ◽  
Effective Science ◽  
The Right

Effective science communication requires assembling scientists with knowledge relevant to decision makers, translating that knowledge into useful terms, establishing trusted two-way communication channels, evaluating the process, and refining it as needed. Communicating Science Effectively: A Research Agenda [National Research Council (2017)] surveys the scientific foundations for accomplishing these tasks, the research agenda for improving them, and the essential collaborative relations with decision makers and communication professionals. Recognizing the complexity of the science, the decisions, and the communication processes, the report calls for a systems approach. This perspective offers an approach to creating such systems by adapting scientific methods to the practical constraints of science communication. It considers staffing (are the right people involved?), internal collaboration (are they talking to one another?), and external collaboration (are they talking to other stakeholders?). It focuses on contexts where the goal of science communication is helping people to make autonomous choices rather than promoting specific behaviors (e.g., voter turnout, vaccination rates, energy consumption). The approach is illustrated with research in two domains: decisions about preventing sexual assault and responding to pandemic disease.

Hegel on Sophocles’ Oedipus the King and the Moral Accountability of Ancient Tragic Heroes

2018 ◽  
Vol 41 (2) ◽  
pp. 159-176 ◽  
Author(s):  
Rachel Falkenstern
Keyword(s):  
Historical Account ◽  
Right Action ◽  
Tragic Hero ◽  
Moral Accountability ◽  
The Right

AbstractThis paper argues that Hegel’s account of subjectivity and agency as historically coined is essential to an accurate understanding of his theory of tragedy. Focusing on Sophocles’ Oedipus the King, I argue that Hegel’s historical account of agency is necessary for understanding his theory of the ancient tragic hero. Although Hegel’s theory of ancient tragedy is often described in terms of a conflict between ethical spheres embodied in two individuals, the conflict in Oedipus is between Oedipus’ deeds and his later knowledge of what has actually occurred. I show how this seemingly subjective conflict is in keeping with Hegel’s theory. Further, while Hegel sees Oedipus as wrong to take full moral accountability for the consequences of his deeds, at the same time, for Hegel, this is the right action for a tragic hero, and the very thing that renders Oedipus timelessly and tragically heroic, rather than a mere victim of fate.

scholarly journals Moral distress: Ethically appropriate actions

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
E Maeckelberghe
Keyword(s):  
Moral Agency ◽  
Moral Distress ◽  
Original Description ◽  
Moral Integrity ◽  
Moral Question ◽  
The Right ◽  
The Given ◽  
Psychological Dimensions ◽  
Original Concept ◽  
Ethical Situation

Abstract Andrew Jameton in 1984 coined the concept of moral distress as: “knowing what to do in an ethical situation, but not being allowed to do it” This original description presupposes that the right moral act can be identified and precludes situations of doubt and uncertainty. The 1984 definition emphasizes barriers that make it impossible for someone to do what they ought to do. Whereas Jameton in a revision in 2013 of his original concept emphasized reduction of the psychological dimensions, Peter& Liaschenko stress the element of moral agency. Moral distress then is a threat to the moral integrity of the professional. This requires three-step ananlysis: first, what is the moral question?; two, what are morally adeguate answers to this question?; three, what ethically appropriate actions are under pressure in the given situation? This will be illustrated with examples from the COVID-19 pandemic.

scholarly journals Recommending Cryptocurrency Trading Points with Deep Reinforcement Learning Approach

2020 ◽  
Vol 10 (4) ◽  
pp. 1506 ◽  
Author(s):  
Otabek Sattarov ◽  
Azamjon Muminov ◽  
Cheol Won Lee ◽  
Hyun Kyu Kang ◽  
Ryumduck Oh ◽  
...  
Keyword(s):  
Reinforcement Learning ◽  
Stock Market ◽  
Historical Data ◽  
Machine Learning Algorithms ◽  
Learning Approach ◽  
Specific Knowledge ◽  
Right Action ◽  
Net Profit ◽  
Market Needs ◽  
The Right

The net profit of investors can rapidly increase if they correctly decide to take one of these three actions: buying, selling, or holding the stocks. The right action is related to massive stock market measurements. Therefore, defining the right action requires specific knowledge from investors. The economy scientists, following their research, have suggested several strategies and indicating factors that serve to find the best option for trading in a stock market. However, several investors’ capital decreased when they tried to trade the basis of the recommendation of these strategies. That means the stock market needs more satisfactory research, which can give more guarantee of success for investors. To address this challenge, we tried to apply one of the machine learning algorithms, which is called deep reinforcement learning (DRL) on the stock market. As a result, we developed an application that observes historical price movements and takes action on real-time prices. We tested our proposal algorithm with three—Bitcoin (BTC), Litecoin (LTC), and Ethereum (ETH)—crypto coins’ historical data. The experiment on Bitcoin via DRL application shows that the investor got 14.4% net profits within one month. Similarly, tests on Litecoin and Ethereum also finished with 74% and 41% profit, respectively.

Moral Distress Research Agenda

2018 ◽  
pp. 103-125
Author(s):  
Carol L. Pavlish ◽  
Ellen M. Robinson ◽  
Katherine Brown-Saltzman ◽  
Joan Henriksen
Keyword(s):  
Research Agenda ◽  
Moral Distress

Final Thoughts (DRAFT)

2018 ◽  
Author(s):  
Robert C. Macauley
Keyword(s):  
Palliative Care ◽  
Moral Distress ◽  
Ethical Dilemmas ◽  
Economic Resources ◽  
Emotional Challenges ◽  
Seriously Ill Patients ◽  
External Forces ◽  
The Right ◽  
Developed World ◽  
Seriously Ill

It is not enough to know how to respond to ethical dilemmas in palliative care. Sufficient resources are required to implement the nuanced approach to ethical dilemmas presented in this textbook. In the developed world, there exists a profound shortage of palliative care clinicians, as well as regulatory barriers which may impede the provision of optimal palliative care. The situation is far more serious in the developing world, where access to symptomatic medications may be severely restricted due to lack of economic resources or bureaucratic barriers. Even when a qualified team is available and necessary tools are at hand, the emotional challenges inherent in caring for seriously ill patients may negatively impact team dynamics. This is particularly true in situations where members of the team believe they know what the “right” thing to do is, but external forces prevent them from doing it, thus causing moral distress.

Individual Moral Perspectives of Professional Nurses

2000 ◽  
Vol 4 (3) ◽  
pp. 35-44 ◽  
Author(s):  
Gail Ann DeLuca Havens,
Keyword(s):  
Nursing Practice ◽  
Moral Distress ◽  
Psychometric Assessment ◽  
Ethical Ideologies ◽  
Professional Nursing Practice ◽  
Professional Nurses ◽  
The Right ◽  
Position Questionnaire ◽  
Insight Into ◽  
Moral Stance

Exploring nurses’ moral perspectives may provide insight into the varying degrees of caring that nurses integrate into their professional nursing practice. Building an understanding of nurses’ moral perspectives also can illuminate the moral experiences of professional nurses who endorse different ethical ideologies, as well as the consequences, such as moral distress, of such experiences. Psychometric assessment of the Modified Ethics Position Questionnaire (MEPQ) yielded a reliable and valid measure of the moral perspectives of practicing nurses. Findings suggest that respondents assumed that desirable consequences can, with the right ethical action, always be obtained. Whether this is a common moral stance among professional nurses requires further inquiry.

Narratives of aggressive care

2013 ◽  
Vol 21 (4) ◽  
pp. 461-472 ◽  
Author(s):  
Elizabeth Peter ◽  
Shan Mohammed ◽  
Anne Simmonds
Keyword(s):  
Nursing Students ◽  
Medical Care ◽  
Moral Distress ◽  
Narrative Approach ◽  
Wait And See ◽  
Medical Uncertainty ◽  
Aggressive Care ◽  
Time Required ◽  
The Right ◽  
Graduate Nursing

Background: While witnessing and providing aggressive care have been identified as predominant sources of moral distress, little is known about what nurses “know” to be the “right thing to do” in these situations. Research objectives: The purpose of this study was to explore what nurses’ moral knowledge is in situations of perceived overly aggressive medical care. Research design: A critical narrative approach was used. Participants: A total of 15 graduate nursing students from various practice areas participated. Findings: Four narrative types were identified, including “Wait and see: medical uncertainty,” “Deflected responsibilities to respond to dying, death, or futility,” “Divergent understandings, responsibilities, and temporalities,” and “Privileged medical understandings and responsibilities.” Discussion: The knowledge of differentially situated persons is acknowledged in dissimilar ways, the time required to determine that enough has been done is perceived differently, and how moral responsibilities are understood also varies. Conclusions: A better understanding of how social roles influence how time, knowledge, and responsibility are related to the provision of aggressive care is needed.

The Need for an Effective Process to Resolve Conflicts Over Medical Futility: A Case Study and Analysis

2016 ◽  
Vol 36 (6) ◽  
pp. 13-23 ◽  
Author(s):  
Jocelyn A. Olmstead ◽  
Michael D. Dahnke
Keyword(s):  
Critical Care ◽  
Policy Development ◽  
Moral Distress ◽  
Medical Model ◽  
Medical Futility ◽  
Critical Care Nurses ◽  
Practice Nurses ◽  
Court Proceedings ◽  
Court Intervention ◽  
The Right

The issue of medical futility requires a well-defined process in which both sides of the dispute can be heard and a resolution reached in a fair and ethical manner. Procedural approaches to medical futility cases provide all parties involved with a process-driven framework for resolving these disputes. Medical paternalism or the belief in the absolute rightness of the medical model will not serve to resolve these disputes. Although medical futility is first determined by medicine, in order for the determination to meet legal criteria, it must be subject to review. The hope is that through a review process that meets legal criteria, the issue can be resolved without the need for court proceedings. If resolution cannot be obtained through this process, surrogates still have the right to seek court intervention. This issue is of relevance and importance in critical care nursing because of the role and position of critical care nurses, who have direct contact with patients and patients’ families, the potential for moral distress in cases of possibly futile treatment, and the expanding roles of nurses, including critical care nurses and advanced practice nurses, in management and policy development.

When healthcare professionals cannot do the right thing: A systematic review of moral distress and its correlates

2016 ◽  
Vol 22 (1) ◽  
pp. 51-67 ◽  
Author(s):  
Giulia Lamiani ◽  
Lidia Borghi ◽  
Piergiorgio Argentero
Keyword(s):  
Ethical Climate ◽  
Healthcare Professionals ◽  
Moral Distress ◽  
Psychological Empowerment ◽  
Empirical Studies ◽  
Psychological Characteristics ◽  
Job Retention ◽  
Preventive Interventions ◽  
The Right ◽  
Do The Right Thing

Moral distress occurs when professionals cannot carry out what they believe to be ethically appropriate actions. This review describes the publication trend on moral distress and explores its relationships with other constructs. A bibliometric analysis revealed that since 1984, 239 articles were published, with an increase after 2011. Most of them (71%) focused on nursing. Of the 239 articles, 17 empirical studies were systematically analyzed. Moral distress correlated with organizational environment (poor ethical climate and collaboration), professional attitudes (low work satisfaction and engagement), and psychological characteristics (low psychological empowerment and autonomy). Findings revealed that moral distress negatively affects clinicians’ wellbeing and job retention. Further studies should investigate protective psychological factors to develop preventive interventions.

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