Conceptualising work-related moral suffering—exploring and refining the concept of moral distress in the context of social work

Abstract

In the nursing literature, work-related suffering due to restricted moral agency is commonly considered under the concept of moral distress. This concept has resonated strongly amongst nursing scholars since the 1980s and has recently gained ground amongst social work scholars as well. However, the research on moral distress suffers from inadequate conceptual clarity; this has led to multiple and disparate ways of empirically studying the phenomenon. This article examines the conceptualisations of moral distress applied in the nursing and social work literature and identifies and discusses the challenges and potential problems related to them. The article sheds light on the complex, dynamic and relative nature of the phenomenon, which has not been sufficiently acknowledged in the existing empirical literature. Despite its complexities and defects, as highlighted in this article, the concept of moral distress can serve as an important tool for understanding and analysing experiences of moral suffering in front line social work. However, defining this experience in all its complexity and devising a valid instrument to measure it remain a major challenge.