An important phenomenon that has recently been receiving increasing attention in nursing and other health care disciplines is that of moral distress. Moral distress is a concept that entered the nursing literature--and subsequently the health care ethics lexicon--in 1984 as a result of the work done by American philosopher and bioethicist Andrew Jameton. Jameton’s initial conceptualization of moral distress pointed to a disjuncture between moral choice and moral action as a consequence of external constraints, with the moral agent experiencing anger, frustration, guilt, and powerlessness as a result (Jameton, 1993; Wilkinson, 1987). The causes associated with moral distress are varied, and include, for example, conflict with other healthcare
