acase@tulane.edu / This dissertation analyzes the difficult moral decisions encountered predominantly in medical contexts. In particular, the notion of moral distress among nurses and physicians has received a great deal of attention in recent literature, and understandably so. Moral distress has been identified as a leading cause of practitioner burnout and staffing shortages, which, in turn, negatively impact patients. Yet, the precise nature and the potentially positive value of moral distress remain relatively unexplored. By incorporating contemporary research on the moral emotions and their significance for moral responsibility, the following work provides a robust account of moral distress, one that challenges the common assessments of its problematic nature.
The project begins by making clear exactly what an account of moral distress should be able to explain and how the most widely cited notions in the existing literature leave significant explanatory gaps. I then propose a comprehensive, analytically robust account that is equipped to explain a wide range of plausible cases. On the view I develop, moral distress is best understood as a tension between agents’ negative emotions and their judgments that they are either not morally responsible for any potential wrongdoing or cannot do anything to improve the circumstances. With this account in mind, I argue for the positive value of moral distress. Although the phenomenon may be associated with undesirable effects, the experience itself appears to be partly constitutive of an honorable character and can reveal and affirm some of our most important concerns as moral agents. Additionally, moral distress bears potentially positive value for others. It provides an appropriate response by which practitioners can take the blame for medical error and thereby help patients and families to move forward. Finally, I examine moral distress and its relationship to compassion fatigue, a commonly associated yet importantly distinct phenomenon. I show that while morally distressed agents are often excused from responsibility, compassion fatigue constitutes a sort of marginal agency. Accordingly, compassion fatigue should be far more alarming and demands policies addressing the condition itself, while the problem of moral distress lies primarily in the circumstances and need not be alleviated directly. / 1 / Daniel Tigard
| Identifer | oai:union.ndltd.org:TULANE/oai:http://digitallibrary.tulane.edu/:tulane_80038 |
| Date | January 2018 |
| Contributors | Tigard, Daniel (author), Shoemaker, David (Thesis advisor), School of Liberal Arts Philosophy (Degree granting institution) |
| Publisher | Tulane University |
| Source Sets | Tulane University |
| Language | English |
| Detected Language | English |
| Type | Text |
| Format | electronic, pages: 170 |
| Rights | No embargo, Copyright is in accordance with U.S. Copyright law. |
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