Moral distress: Ethically appropriate actions

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.