Managing moral distress: A strategy for resolving ethical dilemmas

Conflicts of interest. The boundaries of confidentiality. Right v. right dilemmas. Matters of duty, responsibility, character, and consequence. Ethical issues pervade professional life, and the moral distress they can create requires thoughtful reflection that moves beyond gut intuitions and knee-jerk reactions. This article presents a practical framework for assessing and resolving ethical dilemmas in a sophisticated manner, guided by a circumspect and reflective analysis able to withstand the scrutiny of others and minimize the potential for personal regrets. Central to the analysis set forth in this article's strategy are ‘interrogation questions’—a series of inquiries that draw from the richness of moral philosophy and ethical traditions, while reflecting the practical concerns of contemporary business practices—which guide the decision maker through a comprehensive review of primary considerations. Additionally, the article highlights myriad obstacles that may challenge one's awareness of a moral dilemma, a necessary precondition to employing the strategies of careful analysis and reflective judgment that this article outlines.