Moral Suffering

Moral Suffering

Introduction for Nursing Diagnosis

Moral Suffering is defined as a pain, anguish, or distress caused by a conflict between feelings and a sense of obligation or responsibility. This condition can manifest itself in both physical and emotional symptoms, and it can be triggered by moral situations in social, cultural, or religious settings.

NANDA Nursing Diagnosis Definition

Moral suffering is defined by NANDA International, the world’s largest organization devoted to nursing diagnosis, as “an emotional or spiritual pain related to an internal conflict between one’s beliefs or values and one’s actions.”

Defining Characteristics (Subjectives)

  • Negative emotions such as guilt, anger, or despair
  • Sense of moral conflict
  • Feelings of powerlessness
  • Decreased self-worth or feelings of worthlessness

Defining Characteristics (Objectives)

  • Changes in behavior
  • Verbalizations of experiences
  • Physical signs of distress such as rapid breathing or increased heart rate
  • Increased anxiety levels

Related Factors

  • TransValue Discrepancy: Discrepancy between the patient’s own interpretation of an event or experience and the standards of the individual’s culture or religion
  • Moral Confusion: Lack of clear guidelines or uncertainty about what constitutes a moral action
  • Cultural Norms: Social expectations set by cultural rules or standards that are enforced upon individuals within a particular society

Risk Population

Moralsuffering can affect anyone, however, people who do not have access to resources such as education, psychological assistance or financial stability are more likely to experience this condition due to the lack of support they may receive.

Associated Problems

  • Chronic stress
  • Depression
  • Anxiety
  • Eating Disorders
  • Poor Self-Care
  • Suicidal ideation
  • Substance Abuse

Suggestions of Use

Nursing interventions for moral suffering should focus on helping the patient to become aware of their morality, identify their own values, recognize their moral dilemmas, explore possible solutions and ultimately, make an informed decision.

Suggested Alternative NANDA Diagnoses

  • Powerlessness: Feeling of being unable to control life situations
  • Noncompliance with Therapeutic Regimen: Failure to act according to medical orders
  • Ineffective Coping: Inability to overcome situations or manage them in a healthy way
  • Spiritual Distress: Conflict between individual belief systems and daily living

Usage Tips

  • Explore the patient’s belief system, culture and life experiences.
  • Engage in a non-judgmental discussion to allow the patient to express their feelings and thoughts.
  • Listen and validate the patient’s feelings and provide a space for self-reflection.
  • Help the patient build a bridge between conflicting values and behaviors by exploring alternative solutions.
  • Encourage self-care activities that address the physical and emotional dimensions of moral suffering.

NOC Results

  • Decision Making: Ability to make choices among alternatives that promote health or well-being.
  • Coping: Response to stressful circumstances to minimize impact and adverse effects.
  • Hope: Belief in oneself and a strength to carry on despite difficulty.
  • Spiritual Well-Being: Development and maintenance of meaningful values and beliefs.

NIC Interventions

  • Spiritual Support: Enhancing connections to significant persons, beliefs, and values.
  • Counseling: Provision of services aimed at resolving conflicts, fears, and potential losses.
  • Stress Management Training: Learning methods of relaxation and pain control to reduce feelings of distress.
  • Supportive Listening: Creating a healing environment through active listening, reflecting, and summarizing.


Moral Suffering is a serious condition that can lead to physical and psychological distress. It is important for nurses to recognize the signs of moral suffering and to be prepared to provide the necessary counseling, spiritual support, and stress management needed to help patients address and overcome this condition.


  • How can I help someone who is suffering from moral suffering? Asking questions and engaging in non-judgmental discussions can help the patient to become aware of their inner conflict and explore possible solutions. It is also important to provide emotional support and encourage self-care activities.
  • What are some common signs of moral suffering? Some common signs of moral suffering include negative emotions such as guilt, anger, or despair, sense of moral conflict, decreased self-worth, changes in behavior, verbalizations of experiences, physical signs of distress, and increased anxiety levels.
  • What are some associated risks of moral suffering? Some associated risks of moral suffering include chronic stress, depression, anxiety, eating disorders, poor self-care, suicidal ideation, and substance abuse.

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