TY - JOUR
T1 - Moral Distress Under Structural Violence
T2 - Clinician Experience in Brazil Caring for Low-Income Families of Children with Severe Disabilities
AU - Sale, Ana Carolina Gahyva
AU - Smith-Morris, Carolyn
N1 - Funding Information:
We gratefully acknowledge funding from the following programs at Southern Methodist University: Cary M. Maguire Center for Ethics and Public Responsibility, Richter International Fellowship Program, Hamilton Undergraduate Research Scholars Program, and Engaged Learning Fellowship Program.
Publisher Copyright:
© 2023 The Author(s).
PY - 2023/4/13
Y1 - 2023/4/13
N2 - Rigorous attention has been paid to moral distress among healthcare professionals, largely in high-income settings. More obscure is the presence and impact of moral distress in contexts of chronic poverty and structural violence. Intercultural ethics research and dialogue can help reveal how the long-term presence of morally distressing conditions might influence the moral experience and agency of healthcare providers. This article discusses mixed-methods research at one nongovernmental social support agency and clinic in Rio de Janeiro, Brazil. Chronic levels of moral distress and perceptions of moral harm among clinicians in this setting were both violent, following Nancy Scheper-Hughes' use of that term, and a source of exceptional and innovative care. Rather than glossing over the moral variables of work in such desperate extremes, ethnography in these settings reveals novel skills and strategies for managing moral distress.
AB - Rigorous attention has been paid to moral distress among healthcare professionals, largely in high-income settings. More obscure is the presence and impact of moral distress in contexts of chronic poverty and structural violence. Intercultural ethics research and dialogue can help reveal how the long-term presence of morally distressing conditions might influence the moral experience and agency of healthcare providers. This article discusses mixed-methods research at one nongovernmental social support agency and clinic in Rio de Janeiro, Brazil. Chronic levels of moral distress and perceptions of moral harm among clinicians in this setting were both violent, following Nancy Scheper-Hughes' use of that term, and a source of exceptional and innovative care. Rather than glossing over the moral variables of work in such desperate extremes, ethnography in these settings reveals novel skills and strategies for managing moral distress.
KW - Brazil
KW - ethnography
KW - intercultural ethics
KW - moral distress
KW - structural violence
UR - http://www.scopus.com/inward/record.url?scp=85151519894&partnerID=8YFLogxK
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U2 - 10.1017/S0963180122000779
DO - 10.1017/S0963180122000779
M3 - Article
C2 - 36636810
AN - SCOPUS:85151519894
SN - 0963-1801
VL - 32
SP - 231
EP - 243
JO - Cambridge Quarterly of Healthcare Ethics
JF - Cambridge Quarterly of Healthcare Ethics
IS - 2
ER -