Beyond Moral Distress: Agent-Regret and Lament in Non-Culpable Health Care Acts
Saturday, October 14, 2023
1:15 PM – 2:30 PM ET
Location: Bristol (Third Floor)
A central feature of moral analysis involves determining whether an act is right or wrong and offering an account of the nature of its rightness or wrongness. Moral distress is presumed to arise when an agent is forced to perform a wrong act or constrained from performing a right one. However, this account of moral distress misses much of what is ethically problematic about health care practice. It is the purpose of this paper to describe and analyze the significance of the moral residue that persists beyond any description of the agent’s culpability. I begin by presenting the 2009 Phoenix abortion case and the conflicting moral analyses of it offered by Bishop Thomas Olmsted and M. Therese Lysaught. Rather than defend either account of that dilemma, I point out a feature which both analyses share, namely a focus on the permissibility of an act and a neglect of what Rosalind Hursthouse has called the “moral remainder.” Both views fail to describe how the agent has been involved in doing something terrible even if their action was right. Drawing on Augustine’s account of morally mixed actions and Paul Griffith’s theological taxonomy of regret, I modify Hursthouse’s view and Bernard Williams’s concept of agent-regret to demonstrate the existence of a broad class of actions that require lament even where no wrong-doing has occurred. I conclude that agent-regret for non-culpable actions allows us to substantially broaden the category of what is currently understood to cause moral distress in the provision of health care.