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Nursing Ethics &
Moral Distress
Rels 300 / Nurs 330
October 2015
Nurses as advocates
Within the health care team, no one is likely to
provide greater continuity of care than the nurse
o
o
If the nurse is witness to patient dissatisfaction
with treatment orders, or confusion or
disagreement among the patient’s family, the
nurse is uniquely positioned to make the decisionmaking process explicit
Where teamwork is valued, the nurse can make
valuable contributions to the ethical process by
raising alternative paths & voicing the patient’s
concerns
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Nursing Roadblocks
In some situations, nurses may have to carry out orders that
conflict with their ethical judgement
This may lead to experiences of
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Moral distress – over sub-optimal care plans
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Moral uncertainty – when a decision seems to lead to
turmoil or patient distress
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Subversion of moral agency – when nurses cannot
exercise their own capacity for moral choice or action

Moral residue - personal feelings of guilt, remorse or
inadequacy in providing an excellent standard of
nursing care
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MORAL
DISTRESS
“80% of nurses experience
moral distress at work. It's
one of the main reasons
why nurses quit the
profession.”
(click here) (up to 18:00)
http://www.cbc.ca/whitecoat/blog/20
11/03/24/moral-distress-show/
http://www.cbc.ca/video/news/audio
player.html?clipid=1856555522 (27:30)
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CNA Code of Ethics (2008)
excerpts:
http://www.cnaaiic.ca/CNA/documents/pdf/publications/Code_of_Ethics_2008_e.pdf
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CNA Code of Ethics (2008)
excerpts: http://www.cnaaiic.ca/CNA/documents/pdf/publications/Code_of_Ethics_2008_e.pdf
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What is a person to do?
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Be ethically knowledgeable
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Be alert for and aware of power dynamics
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know your moral theories
know your principles of health care ethics
learn to analyze and articulate your own moral concerns
and judgements
between doctor & patient
between doctor & other health care professionals
among nurses, patients and loved ones
Ensure communication excellence on behalf of health
care providers and patients
Learn to be advocates for colleagues and patients
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