Moral anguish: what it is and why we suffer from it

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Robert Maurer

Moral anguish: what it is and why we suffer from it

Sometimes society or even the very circumstances of life force us to act against our wishes or even our values. The suffering that comes from these experiences is often not sufficiently taken into account.

Written and verified by the psychologist GetPersonalGrowth.

Last update: 15 November 2021

We have all probably experienced so-called moral anguish at one time or another in our lives. It pops up when we do something that goes against our values. It is the eternal contradiction between duty and desire, between what is dictated by the heart and what is dictated by circumstances. Life flows through these ambivalent channels where things are not always as we would like.

We could give a thousand examples. Health professionals experience it every day: doctors, nurses and health workers who work in precarious conditions and cannot care for patients as they deserve. Each of us experiences it when, for example, we have no choice but to put our grandfather or parent with Alzheimer's in a nursing home because we don't have all the necessary resources.

It also happens when we take our children to kindergarten because we work and cannot be with them. Day to day, we experience that suffering in which conscience, emotions, values ​​and the annoying contradiction collide.

What is moral anguish?

The term "moral distress" first appeared in 1984 thanks to philosopher Andrew Jameton. It was he who described an increasingly common phenomenon in our society. As Jameton explained, humanity has reached a point where institutional barriers are challenging our core moral principles and our ethical responsibilities.

We experience this reality because of the way the labor market is structured, for example. We are rarely allowed to reconcile family life with professional life, which causes moral anguish. We would like to spend more time with our partner and / or children. However, insufficient schedules and policies are a major obstacle.

The reality is clear. We are not mistaken in saying that current circumstances are increasing this dimension. Healthcare workers have to deal with the moral distress caused by the overcrowding of the facilities. Companies and workers often face morally painful situations.

It is also about a psychological reality that is difficult for many people to manage. For example, when an employer is forced to fire some employees because his business is no longer profitable, he enters this dimension of devastating personal and ethical suffering.

The suffering we feel when we cannot act with integrity

A study conducted by the University of Valencia shows that moral distress has a significant impact in the nursing field. We are facing one of the greatest human and health tragedies that humanity has lived and this affects many segments of the population. Undoubtedly, the most affected is the field of health.

This research work highlights that the emotional impact comes from those situations in which people are unable to say goodbye to their relatives. Losses without goodbyes are a great source of stress. The suffering that comes from being unable to act with the integrity they would like requires a heavy sacrifice to health professionals.

Moral anguish, something we are not prepared for

Moral distress arises when we detect something that is wrong and are unable to act as we would like. Indeed, blocking this behavior and repressing our ethical response to a particular event goes against our very nature.

The brain is programmed to detect threats or risky situations and act accordingly. We can fight (answer) or flee (run away to survive). However, when we identify something that is not right and are prompted to "not act", stress and emotional distress are activated in our body.

Not being able to visit the elderly in nursing homes in this context of health alarm, for example, hurts and contradicts our moral principles.

We know that not doing so safeguards their well-being, but even so the mind cannot help but feel great moral restlessness. The lack of emotional and social contact with our elderly family members is undoubtedly devastating per entrambi.

The solution is to cultivate moral resilience

Cynda Hylton Rushton is an academic specializing in clinical ethics and a professor of nursing and pediatrics at John Hopkins University. You have introduced a term worth remembering and keeping in mind: moral resilience.

The purpose of moral resilience is to alleviate and manage suffering caused by the ethical and moral challenges we experience on a daily basis. To work on this dimension, we must take the following into consideration:

  • We cannot control the circumstances, but we can control our emotions.
  • The emotions we feel in situations that cause us moral distress must not be hidden or overlooked. We must accept them, release them, manage them and share them with others to normalize them and thus have more control over them.
  • We try not to punish or judge ourselves for actions that may not correspond to our values. Life is uncertain and we cannot have absolute control over our surroundings. Sometimes the best alternative is not the right one, but it is the one that is necessary under the circumstances.
  • The mere fact of suffering reminds us that our values ​​and principles are still intact within us.
  • It is essential to share the pain we have suffered with others. Create support groups and talk to friends and family it can help us deal with moral distress.

Last but not least, it is necessary to make sense of the challenges we face. Even in a world steeped in chaos, many of the things we do have meaning. Maybe today we struggle to find it, but tomorrow we will undoubtedly understand it better.


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