Values out of whack<\/p>\n
As a nation, our actions are out of alignment with our values.<\/p>\n
We are overwhelmed by the constant barrage of toxic messages and distressful events that shape our sense of who we are as a society and negatively affect our physical and mental health. We have seen, and some have personally experienced, the horrific public health impact of the resurgence of preventable diseases<\/a> and deaths from measles, a disease that had been eradicated<\/a> from the U.S.<\/p>\n As nurses, we have seen how words are used to evoke false beliefs<\/a>. We have never seen a \u201cvat\u201d of solution injected into any person \u2014 let alone an infant, as President Donald Trump recently claimed<\/a> about the childhood vaccination regimen. We have witnessed the fear and confusion of parents related to the mixed messages coming from non-pediatricians about the value of childhood vaccinations. Why change the vaccination schedule without evidence?<\/a><\/p>\n We see reductions and disinvestments in essential research funding that will hurt Americans waiting for scientific breakthroughs<\/a>. Discouraging the next generation of investigators threatens our standing as a global leader in research innovation.<\/p>\n We experience ourselves the rising costs of life\u2019s necessities, such as food, housing, and healthcare<\/a>. And we endure public coarseness and disgraceful conduct among those elected to represent us<\/a>, increasingly characterized by contempt and by labeling those with whom they disagree as \u201cradicals,\u201d \u201csocialists,\u201d \u201cfascists,\u201d or worse.<\/p>\n These developments are not mutually exclusive, and they represent a troubling sign for a country where trust in the values of public institutions and in government leaders and workers is being eroded by outright lies and a lack of mutual respect. In 2025, only 17% of Americans trusted the government to do \u201cwhat is right.\u201d<\/a><\/p>\n Moral distress occurs when one\u2019s values are constrained because of institutional, social, political, or other barriers.<\/p>\n Moral distress occurs when one\u2019s values are constrained because of institutional, social, political, or other barriers.<\/p>\n The concept is often applied to healthcare workers, such as nurses. For example, moral distress has been widely documented when nurses are unable to deliver a treatment they know is best because of restraints imposed by the healthcare system in which they work.<\/p>\n Repeated experiences of moral distress<\/a> often lead to a sense of disillusionment, disengagement, moral outrage, burnout, and apathy. When this moral distress and resulting harm is experienced by a broad swath of the general population, we call this civic moral distress<\/a>.<\/p>\n So what can we do?<\/p>\n We know respectful dialogue instead of derision advances collaborative agendas and builds solid coalitions. We know public health is key to the prevention of disease. We know respect for the dignity of our fellow humans has nothing to do with their age, race, gender, political ideology, or immigration status. We know a lack of basic healthcare leads to emergency room visits and higher costs. We know the average citizen is not being heard by those who represent them to address the broader societal and moral problems at home and feels powerless to change any of it.<\/p>\n Don\u2019t be disillusioned<\/p>\n There are no easy antidotes to civic moral distress. Experts coalesce around key principles, grounded in a foundation of trust, that could move us from a morally distressed nation to one characterized by moral strength and integrity.<\/p>\n For everyone: Be kind, be truthful, perform one random act of kindness every day, care for your neighbors. For newspapers: Publish one issue a week that focuses on local community issues. For all government officials: Don\u2019t break everything just because you can; stay in your lane and do not make healthcare recommendations out of your area of expertise.<\/p>\n For all Americans: Do not be disillusioned.<\/p>\n Advancing this agenda will require significant moral courage. Failing to do so will further erode our society, our humanity. And although civic moral distress is our current reality, it need not be our future.<\/p>\n
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