Moral distress in healthcare assistants: a discussion with recommendations

Daniel Rodger, Bruce Blackshaw, Amanda Young

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background: Moral distress can be broadly described as the psychological distress that can develop in response to a morally challenging event. In the context of healthcare, its effects are well documented in the nursing profession, but there is a paucity of research exploring its relevance to healthcare assistants.

Objective: This article aims to examine the existing research on moral distress in healthcare assistants, identity the important factors that are likely to contribute to moral distress, and propose preventative measures.

Research Design: This is a survey of the existing literature on moral distress in healthcare assistants. It uses insights from moral distress in nursing to argue that healthcare assistants are also likely to experience moral distress in certain contexts.

Participants and Research Context: No research participants were part of this analysis.

Ethical Considerations: This article offers a conceptual analysis and recommendations only.

Findings: The analysis identifies certain factors that may be particularly applicable to healthcare assistants such as powerlessness and a lack of ethical knowledge. We demonstrate that these factors contribute to moral distress.

Discussion: Recommendations include various preventative measures such as regular reflective debriefing sessions involving healthcare assistants, nurses and other clinicians, joint workplace ethical training, and modifications to the Care Certificate. Implementation of these measures should be monitored carefully and the results published to augment our existing knowledge of moral distress in healthcare assistants.

Conclusion: This analysis establishes the need for more research and discussion on this topic. Future research should focus on evaluating the effectiveness of the proposed recommendations.
Original languageEnglish
JournalNursing Ethics
Early online date22 Aug 2018
Publication statusE-pub ahead of print - 22 Aug 2018


  • care homes
  • ethics education
  • healthcare assistants
  • mental health/psychiatry
  • moral distress
  • moral events
  • moral sensitivity


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