The Moral Consequences of Context: An Analysis of Bradshaw and Colleagues' Model of Moral Distress for Military Healthcare Professionals

Abstract

Military healthcare professionals (HCPs) may experience moral distress during international deployment. Moral distress is experienced when a HCP faces a moral dilemma, e.g., knows the morally correct course of action but is blocked from taking it, or where all available courses of action require something of moral significance be given up. While the literature indicates that moral distress often negatively impacts the mental health of the individual and the effectiveness of the organization, limited research has examined moral distress amongst military HCP. Many similar stressors and psychological health problems are present for both civilian and military HCP; however, the unique context of deployment necessitates further examination. This thesis explores the military HCP experience with moral distress by using Bradshaw and colleague’s model of progression from the encounter with a moral dilemma to the impact on individuals and organizations. Through the analysis of novel interviews collected by the Ethics in Military Medicine Research Group (EMMRG), Bradshaw and colleague’s model of military moral distress is compared to participant’s experiences and qualitatively analysed, with the results outlining where the model is supported and where refinement is recommended. These challenges were then supported by a literature review from the disciplines of virtue and feminist ethics, moral psychology, bioethics, and civilian HCP moral distress research. Two novel and significant revisions to the model are suggested: representing and integrating the cumulative experience of moral distress, and re-conceptualizing the resolution process based on the consideration of contextual controllability on moral responsibility.