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Ritualized Futility via Clinical Momentum at the End of Life in the Intensive Care Unit: An Ethical Inquiry into Moral Distress in Nurses as a Response to a Culturally Mediated Healthcare System Failure

Abstract Details

2020, Master of Arts, Ohio State University, Bioethics.
Moral distress is often framed as arising from interpersonal conflict such as moral disagreement. Within the dynamics of disagreement, moral distress becomes linked to power differentials present between the conflicting parties. As such, the understanding of the concept has commonly become dependent on constraints inherent to the nurse’s professional role. Within this metanarrative of professional powerlessness, the proposed mitigation strategies have been narrowly focused. Given the widespread nature of moral distress they have also been largely ineffective. While moral distress in nursing remains pervasive, the majority of Americans are not dying well. The institutionalized deathbed in modernity is unlike any that have come before it. This paper traces death’s trajectory of change exposing how technology and medicalization have come to authorize and direct the dying process. Spiritual needs of the dying have become obscured if not altogether denied. This has led to new rituals developing at the bedside of the dying. In the critical care environment, the ritualization of futility has become a culturally and institutionally mediated phenomenon. Americans not dying well and moral distress development in nurses may stem from the same healthcare system failures. In this scenario, effective mitigation will require large scale change. The profession of nursing is poised to be an integral partner in the collaboration necessary to affect just such a transformative change.
Matthew Vest, Dr. (Advisor)
Courtney Thiele (Committee Member)
113 p.

Recommended Citations

Citations

  • McClure, A. C. (2020). Ritualized Futility via Clinical Momentum at the End of Life in the Intensive Care Unit: An Ethical Inquiry into Moral Distress in Nurses as a Response to a Culturally Mediated Healthcare System Failure [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1587082543896911

    APA Style (7th edition)

  • McClure, Anne. Ritualized Futility via Clinical Momentum at the End of Life in the Intensive Care Unit: An Ethical Inquiry into Moral Distress in Nurses as a Response to a Culturally Mediated Healthcare System Failure. 2020. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1587082543896911.

    MLA Style (8th edition)

  • McClure, Anne. "Ritualized Futility via Clinical Momentum at the End of Life in the Intensive Care Unit: An Ethical Inquiry into Moral Distress in Nurses as a Response to a Culturally Mediated Healthcare System Failure." Master's thesis, Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1587082543896911

    Chicago Manual of Style (17th edition)