TY  - JOUR
T1  - Moral Distress and Ethical Decision-Making among Nurses Caring for Patients with Advanced Illness
A1  - Grace Okafor
A1  - Martin Jensen
A1  - Elena Rossi
A1  - David Park
JF  - Journal of Integrative Nursing and Palliative Care
JO  - J Integr Nurs Palliat Care
SN  - 3006-5550
Y1  - 2026
VL  - 7
IS  - 1
DO  - 10.51847/dAnTmjKEin
SP  - 237
EP  - 246
N2  - Nurses caring for people with advanced illness face decisions in which patient preferences, expected benefit, treatment burden, family expectations, professional duties, and organizational realities may conflict. Ethical difficulty alone, however, does not establish moral distress. This article develops an ethical decision and moral-resilience account that separates the morally salient event, the nurse’s appraisal, practical capacity to speak or act, criterion-based moral distress, persistence as moral residue, and conditions supporting recovery. Professional power and voice, ethical climate, resource constraints, recurrent exposure, reflective practice, and interprofessional ethics support are treated as interacting conditions rather than interchangeable causes. The central contribution is a conditional framework in which moral distress is most plausible when a morally consequential concern remains unresolved or cannot be ethically accommodated, while later outcomes depend on recurrence and multilevel support. Moral resilience is interpreted as professional ethical capacity, not a substitute for organizational responsibility.
UR  - https://journalinpc.com/article/moral-distress-and-ethical-decision-making-among-nurses-caring-for-patients-with-advanced-illness-xmn84fxbt1okko3
ER  -