Understanding Moral Outrage

Understanding Moral Outrage

In health care and the communities where we live, national and world events are shaping our future. When confronted with situations where we feel our ethical values are violated, it is a natural and human response to feel morally outraged. As has always been though, there are opposing views to everything. So, how do we work through these challenges while maintaining our integrity? As health care providers and people, we need to understand how our reactions to situations like this can likely define the outcome.

In my article “Principled Moral Outrage: An Antidote to Moral Distress?,” I examine how moral distress can often become outrage and why this happens. In the world of clinicians, moral outrage can arise when a patient is experiencing extreme suffering and the nurse doesn’t feel treatment is working, but the family has requested that life sustaining therapies be delivered at all costs. The clinician experiences a moral dilemma because the role of a nurse is to promote and protect health and ease suffering, and yet they see the patient suffering appears to be disproportionate to the benefit. While the strong emotions one feels are a signal that there is a moral problem, we must respond in a way that is principled and reflects a balanced stance of wisdom and compassion and preserves integrity.

We also see moral outrage outside of health care and in other settings where we work and live. Continuous access to news and media can make it difficult to find reprieve when there is a feeling that ethical standards have been violated. If we aren’t careful, we can find this violation turning into unregulated moral outrage and causing damage to our reputation and those around us.

My paper offers tools and ways of thinking that can help us make sure our moral distress becomes principled moral outrage instead of unprincipled:

  • Notice your body, emotions, and thoughts and how they are affecting your reaction
  • Pause, breath, and reflect
  • Connect to your core values and intentions
  • Notice your assumptions and bias
  • Monitor the tone of your discussion
  • Engage in ethical discernment and analysis

It’s important to remember that in health care and all settings, we are responsible for our own actions, and when circumstances occur that violate our beliefs, it’s our responsibility to respond in a way that is ethical and principled.

Stay tuned to the Isabel Hampton Robb Nursing Ethics series for more to come on principled—and unprincipled—moral outrage.


Cynda Hylton Rushton is the Anne and George L. Bunting Professor of Clinical Ethics in the Johns Hopkins Berman Institute of Bioethics and the School of Nursing, with a joint appointment in the School of Medicine’s Department of Pediatrics. Her current scholarship in clinical ethics focuses on moral distress and suffering of clinicians, the development of moral resilience, palliative care, and designing a culture of ethical practice.

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