Moral Distress and the Health Care Organization

A health care professional may experience moral distress when she believes she knows the ethical course of action in a given situation, but is unable to enact that plan, or must do otherwise. This dissertation argues that health care organizations have an ethical obligation to address moral distress in their health care professionals, and that common responses to moral distress are ethically insufficient due to their reliance on hierarchical solutions when hierarchies are, in fact, often a cause of moral distress. Thus, health care organizations, as moral agents, have a responsibility to find a non-hierarchical response to moral distress. In this dissertation, a non-hierarchical response to moral distress is developed, based on the concept of a content-thin common moral framework shared by health care professionals, which arises from their common professional morality. In the tradition stemming from Engelhardt’s “moral friends” and “moral strangers,” this content-thin common moral framework implies that health care professionals are “moral acquaintances” who understand each others’ moral viewpoints and share them in part, as they work together to fulfill the goals and values of professional health care. Given this moral acquaintanceship, this dissertation shows that Habermas’ theory of discourse ethics can provide the rules and grammar for a non-hierarchical content-thin procedural response that health care organizations can appeal to in order to resolve moral distress in health care professionals