Moral Agency in Healthcare: What Does It Mean?

Healthcare is a massive sector in America. It is incredibly important that healthcare professionals, even those still completing nurse practitioner schooling, behave ethically and morally. When a human being’s health and well-being are your main responsibility, it makes sense to do the right thing for your patients. 

Moral agency, as defined by the American Association of Colleges of Nursing, is ”having the intent and then acting to pursue, achieve, and maintain optimal beneficial outcomes consistent with the moral/ethical principles of one’s practice.”

This article will discuss moral agency in healthcare. We’ll cover what it is, how it applies in this sector, and some key related concepts. By the time you’ve finished reading, you’ll have a full understanding of this topic, so continue reading to learn more.

What is Moral Agency?

We’ve shared the definition above; however, let’s go into some more in-depth detail now. 

A moral agent is a person who can tell right from wrong and is held accountable for his or her actions. Moral agents have a moral responsibility not to cause unjustified harm, which is especially important in a healthcare setting. 

Traditionally, moral agency is usually assigned only to those who can be held responsible for their actions. Children and adults with certain mental or intellectual disabilities may have little or no capacity to be moral agents. Adults with full mental capacity relinquish their moral agency only in extreme situations, like being held hostage or during a war. 

By expecting people to act as moral agents, we hold people accountable for the harm they cause others. This is why laws exist. However, questions arise. Do corporations have moral agency? Will robots have moral agency as artificial intelligence develops? These sorts of questions have kept philosophers nice and busy throughout mankind’s history. 

How Does Moral Agency Apply in Healthcare?

Moral agency in healthcare is the term given to the ability and responsibility of healthcare professionals and healthcare companies to make ethical decisions in the best interests of patients while navigating certain complex moral dilemmas. This concept requires an awareness of key ethical principles such as autonomy, beneficence, doing no harm, and ensuring that healthcare decisions align with both professional obligations and an individual patient’s needs.

Healthcare providers need to balance their professional medical knowledge and practice with compassion, recognizing that ethical decision-making is not always clearly apparent and often involves competing values depending on the circumstances. The moral duty to respect patient autonomy can sometimes conflict with the principle of beneficence in the medical context, as seen in cases where patients refuse life-saving treatment or resuscitation. Moral agency also extends to systemic issues, which may require healthcare professionals to advocate for morally just policies and equitable access to care, even in the face of institutional constraints, particularly in the U.S., where the healthcare system can be rife with issues. 

The emotional burden of ethical decision-making in healthcare can be significant, leading to moral distress for practitioners when certain external factors prevent professionals from acting in alignment with their ethical convictions or their organization’s values. Continuous ethical reflection and dialogue within the healthcare sector is essential for workers to maintain moral integrity and foster an environment where ethical concerns can be raised, discussed, and addressed. Cultivating moral agency requires staff to proactively engage in education, seek support, and foster a commitment to patient-centred care that prioritizes ethical principles alongside clinical excellence and medical best practice. 

Related Concepts

Let’s spend some time going over some related concepts, such as moral uncertainty, moral dilemmas, and moral distress. 

Moral Uncertainty 

Situations of moral uncertainty in healthcare may arise when medical professionals face ethical dilemmas without easy answers. These dilemmas may often involve conflicting values, ambiguous guidelines, or unforeseen consequences for patients. Moral uncertainty can emerge in situations such as end-of-life decisions, healthcare resource allocation, or balancing the need for patient autonomy with medical judgment. We’ll share more on common moral dilemmas in healthcare now. 

Moral Dilemmas

Moral dilemmas in healthcare might arise when ethical principles conflict, forcing staff to make difficult decisions with no clear right or wrong answer. For instance, end-of-life care situations present a significant challenge for staff, as healthcare providers may have to decide whether to continue life-sustaining treatment for terminally ill patients, particularly when patient wishes are unclear or are at odds with family opinions and wishes.

Another moral dilemma in healthcare is the balance between individual patient autonomy and the principle of beneficence, especially when patients refuse treatment that could either save or significantly improve their lives. 

Resource allocation issues can also create ethical strain and a crux moral dilemma, as limited medical supplies, ICU beds, and organ transplants need to be distributed fairly, often leaving some patients without necessary care or even resulting in death. 

Informed consent is a further concern, and this requires that patients fully understand the risks and benefits of surgical procedures, which becomes further complicated when someone has cognitive impairment or their families interfere in the treatment. 

Medical futility is another moral dilemma that arises when continuing treatment is unlikely to improve a patient’s condition, yet family members may insist on prolonging care. 

Confidentiality also becomes a moral dilemma when protecting patient privacy conflicts with the duty to warn others, such as in cases of infectious diseases, harm to others, or self-harm risks. 

Moral Distress 

Moral uncertainty and moral dilemmas in a healthcare setting can lead to moral distress as healthcare providers struggle with the fear of making the wrong choice or causing harm. Navigating such situations requires healthcare professionals to engage in ethical reflection, open dialogue, and seek institutional support to ensure that healthcare decisions align with both professional integrity and patient well-being.