Moral distress

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Read the article Prestia (2020) located in Additional Resources and discuss the following:

Provide an example of moral distress within your workplace (current or past) that is not discussed in the article.
Evaluate methods nurse leaders can use to address moral distress.
Discuss the impact of moral obligation on staff and nurse leader responsibilities.
Prestia, A.S. (2020). The moral obligation of nurse leaders: COVID-19. Nurse Leader, 18(4), 326-328. https://www.nurseleader.com/article/S1541-4612(20)30098-7/fulltext

Sample Solution

One example of moral distress in the workplace that is not discussed in the article by Prestia (2020) is when a nurse leader has to make a decision that goes against their beliefs and values. For instance, I have worked in an ICU setting where a patient was suffering from cardiac issue, but due to religious reasons, the patient and family requested for treatment to be withheld. The team felt morally obligated to do as the family wished, however, it went against what nurses typically deem best practice for critical care patients. This situation put many staff members in distress as they felt torn between honoring their ethical principles of providing quality care while adhering to the wishes of those involved.

Nurse leaders can utilize various methods to address moral distress with their teams. Firstly, nurse leaders should provide support and guidance that allows nurses to voice any concerns or feelings associated with their work (Prestia 2020). Leaders should create an environment where staff feel comfortable enough share how situations affect them emotionally and professionally without fear of judgement or reprisal (Salas et al., 2010). Additionally, nurse leaders should encourage nurses’ autonomy while advocating for resources and assistance when needed (Prestia 2020). Lastly, it is important for leadership to facilitate interprofessional collaboration sessions which focus on effective communication techniques aimed at addressing difficult conversations involving ethical dilemmas thereby decreasing conflict among team members (Fukada et al., 2018).

In conclusion, moral distress can have significant implications on both individuals and organizations if not addressed properly. Although Prestia’s article does discuss common causes of moral distress among healthcare professionals such as inadequate staffing levels or lack of resources; there are additional scenarios such as conflicting values that may also lead clinicians feeling distressed about their work. Nurse leaders are essential in creating spaces where nurses can express these challenging emotions safely through open dialogue while also ensuring policies and practices reflect ethical standards expected within health care settings.

First, it is never just to intentionally kill innocent people in wars, supported by Vittola’s first proposition. This is widely accepted as ‘all people have a right not to be killed’ and if a soldier does, they have violated that right and lost their right. This is further supported by “non-combatant immunity” (Frowe (2011), Page 151), which leads to the question of combatant qualification mentioned later in the essay. This is corroborated by the bombing of Nagasaki and Hiroshima, ending the Second World War, where millions were intently killed, just to secure the aim of war. However, sometimes civilians are accidentally killed through wars to achieve their goal of peace and security. This is supported by Vittola, who implies proportionality again to justify action: ‘care must be taken where evil doesn’t outweigh the possible benefits (Begby et al (2006b), Page 325).’ This is further supported by Frowe who explains it is lawful to unintentionally kill, whenever the combatant has full knowledge of his actions and seeks to complete his aim, but it would come at a cost. However, this does not hide the fact the unintended still killed innocent people, showing immorality in their actions. Thus, it depends again on proportionality as Thomson argues (Frowe (2011), Page 141).
This leads to question of what qualifies to be a combatant, and whether it is lawful to kill each other as combatants. Combatants are people who are involved directly or indirectly with the war and it is lawful to kill ‘to shelter the innocent from harm…punish evildoers (Begby et al (2006b), Page 290).However, as mentioned above civilian cannot be harmed, showing combatants as the only legitimate targets, another condition of jus in bello, as ‘we may not use the sword against those who have not harmed us (Begby et al (2006b), Page 314).’ In addition, Frowe suggested combatants must be identified as combatants, to avoid the presence of guerrilla warfare which can end up in a higher death count, for example, the Vietnam War. Moreover, he argued they must be part of the army, bear arms and apply to the rules of jus in bello. (Frowe (2011), Page 101-3). This suggests Frowe seeks a fair, just war between two participants avoiding non-combatant deaths, but wouldn’t this lead to higher death rate for combatants, as both sides have relatively equal chance to win since both use similar tactics? Nevertheless, arguably Frowe will argue that combatant can lawfully kill each other, showing this is just, which is also supported by Vittola, who states: ‘it is lawful to draw the sword and use it against malefactors (Begby et al (2006b), Page 309).’
In addition, Vittola expresses the extent of military tactics used, but never reaches a conclusion whether it’s lawful or not to proceed these actions, as he constantly found a middle ground, where it can be lawful to do such things but never always (Begby et al (2006b), Page 326-31). This is supported by Frowe, who measures the legitimate tactics according to proportionality and military necessity. It depends on the magnitude of how much damage done to one another, in order to judge the actions after a war. For example, one cannot simply nuke the terrorist groups throughout the middle-east, because it is not only proportiona

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