Moral Distress and Austerity: An Avoidable Ethical Challenge in Healthcare

Georgina Morley*, Jonathan Ives, Caroline Bradbury-Jones

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

15 Citations (Scopus)
192 Downloads (Pure)


Austerity, by its very nature, imposes constraints by limiting the options for action available to us because certain courses of action are too costly or insufficiently cost effective. In the context of healthcare, the constraints imposed by austerity come in various forms; ranging from the availability of certain treatments being reduced or withdrawn completely, to reductions in staffing that mean healthcare professionals must ration the time they make available to each patient. As austerity has taken hold, across the United Kingdom and Europe, it is important to consider the wider effects of the constraints that it imposes in healthcare. Within this paper, we focus specifically on one theorised effect – moral distress. We differentiate between avoidable and unavoidable ethical challenges within healthcare and argue that austerity creates additional avoidable ethical problems that exacerbate clinicians’ moral distress. We suggest that moral resilience is a suitable response to clinician moral distress caused by unavoidable ethical challenges but additional responses are required to address those created because of austerity. We encourage clinicians to engage in critical resilience and activism to address problems created by austerity and highlight the responsibility of institutions to support healthcare professionals in such challenging times.
Original languageEnglish
Pages (from-to)185-201
Number of pages17
JournalHealth Care Analysis
Issue number3
Early online date17 Jul 2019
Publication statusPublished - 15 Sep 2019


  • Critical resilience
  • Moral resilience
  • Resilience
  • Feminist empirical bioethics
  • Empirical bioethics
  • Phenomenology
  • Nursing
  • Bioethics
  • Moral distress
  • Austerity


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