TABLE 1

Recognizing moral distress in oneself and others²

Type of moral distress	You are feeling distressed because…	Common emotions	Trigger phrases
MORAL-CONSTRAINT DISTRESS	You are constrained from doing what you think is the ethically appropriate action.	Angry, frustrated, sense of injustice, powerless	“I feel like I’m not doing the right thing.” “I feel like I am complicit in causing suffering.”
MORAL-UNCERTAINTY DISTRESS	You are uncertain about whether you are doing the right thing.	Torn, conflicted, uncertain, frustrated	“I feel torn about what we should do.” “I don’t know whether this is the right thing to do.”
MORAL-DILEMMA DISTRESS	You are unable to choose between 2 or more ethically supportable options.	Guilt, regret, torn, sense of injustice, sad	“I feel like I’m stuck between a rock and a hard place.” “Both options seem to be equally bad.”
MORAL- CONFLICT DISTRESS	You are conflicted about the most appropriate ethical action.	Conflicted, frustrated, angry, sad	“I feel like they don’t understand my point of view.” “I feel like we have different moral perspectives.”
MORAL-TENSION DISTRESS	You are unable to share your beliefs with others (this might include your colleagues, manager, or other providers).	Sad, angry, frustrated, powerless	“I don’t feel like I can talk to anyone about my beliefs.”