title: Moral distress reexamined: a feminist interpretation of nurses' identities, relationships, and responsibilites.
abstract: Moral distress has been written about extensively in nursing and other fields. Often, however, it has not been used with much theoretical depth. This paper focuses on theorizing moral distress using feminist ethics, particularly the work of Margaret Urban Walker and Hilde Lindemann. Incorporating empirical findings, we argue that moral distress is the response to constraints experienced by nurses to their moral identities, responsibilities, and relationships. We recommend that health professionals get assistance in accounting for and communicating their values and responsibilities in situations of moral distress. We also discuss the importance of nurses creating "counterstories" of their work as knowledgeable and trustworthy professionals to repair their damaged moral identities, and, finally, we recommend that efforts toward shifting the goal of health care away from the prolongation of life at all costs to the relief of suffering to diminish the moral distress that is a common response to aggressive care at end-of-life.
authors.affiliation: Lawrence S. Bloomberg Faculty of Nursing Member, Joint Centre for Bioethics, University of Toronto, Suite 130-155 College St., Toronto, ON, M5T 1P8, Canada, elizabeth.peter@utoronto.ca.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Peter
authors.forename: Joan
authors.initials: J
authors.lastname: Liaschenko
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D003220:Conflict, Psychological; D003695:Delivery of Health Care / Q000941:ethics*; D004993:Ethics, Nursing; D019513:Feminism; D006801:Humans; D008020:Life Support Care; D011361:Professional Competence; D024382:Professional Role; D013315:Stress, Psychological