Introduction

Moral distress exists at epidemic levels, but most of its sufferers and potential doctors do not have the vocabulary to describe it. As long as moral distress remains unchecked, it self-perpetuates and spreads throughout schools and societies. This essay seeks to follow a handful of earlier researchers in introducing the teaching world to moral distress. Developing a thorough awareness of moral distress is urgent: “The adoption of a theoretical model of moral distress allows the visualisation of everyday situations, often perceived as ordinary, but frequently hiding traps, devices and strategies of subjectivation” (Devos Barlem & Souza Ramos, 2014, p. 6). After defining terms, this essay details moral distress’ parasitic relationship with the L2 classroom. That will be followed by an examination of its causes, methods of propagation, and finally a review of strengths and weaknesses in moral distress research within pedagogy.

Definitions

Three definitions are central to this discussion: that of moral distress itself, its causational partner, morally injurious experiences (MIEs), and networks (particularly, social networks).

Moral distress is a form of distress that corresponds to damage to one’s sense of what is right. Persons suffering moral distress typically feel decreased ability to trust, to advocate or self-advocate, and, naturally, intense stress. Severe cases can cause a breakdown of a person’s moral framework. Moral distress damages the affective state itself. Moral distress has also been found to potentially produce other severe mental ills such as PTSD and burnout (Currier et al., 2015).

MIEs can intuitively be defined as any event that produces moral distress. The term itself suggests how moral distress arises; a person experiences something that injures their sense of morality. These experiences are qualitatively diverse. The injury can come from failing to live up to one’s own expectations, that is, underperforming morally. The injury can also come from viewing others underperform, or cause harm. In short, MIEs are any sort of event that “challenge[s] one’s deeply held moral beliefs and values as well as possibly threatening death or injury” or otherwise “violate[s] deeply held moral values/beliefs” (Currier et al., 2015). Another scenario is a clash of moral systems, where a person may feel their own sense of right threatened or their commitment to doing good weakened. Most literature refers to moral distress rather than MIEs, however, the concepts are intimately related. In particular, distinguishing MIEs as the causational component and moral distress as the resultant component makes for clearer discussion.

Vachová (2019) alone identifies over 65 types of MIE typically encountered by teachers. A familiar handful of these teacher-specific MIEs include: “Required participation in school events cut down the time available for preparation for my teaching” (509). “I know that some colleagues set a bad example by their behaviour towards their pupils” (510). “I have to work with pupils with special educational needs even though it is not within my professional competencies” or “I do not have enough information for the elaboration of an individual educational plan” (511). “When I inform OSPOD (the [Czech] agency for the social-legal protection of children), I have concerns as to whether I will not cause more harm to the pupil” (511).

Beyond commonly recognizable MIEs where the typical person’s sense of morality is threatened, it is important to understand that some MIEs will be more intimate in definition and character. The fact that most people would not be affected by a given event does not mean an MIE and the moral distress resultant will not be any less real for the victim. What constitutes an MIE will vary from one person to the next.

The term network, as it is used here, is an abstract structure composed of connected objects. The connections may represent any manner of real or abstract connections and the objects may be any sort of real or abstract object. When studying social networks within schools, typical objects are students, teachers, administrators, and even entire schools. Connections may be teacher-student interaction, friendships, bonds of trust, mentorships, supervisor-supervisee relationships, and so on.

Social networks are a class of networks whose connections are social in nature. This type of network is valuable for studying moral distress because MIEs typically happen within preexisting social networks and affect the network structure itself. It is noted here that the common usage of the term social network to refer to sites like Facebook and Twitter is correct, but overly narrow, as many social networks exist outside the Internet. Many social networks exist simultaneously within schools. For instance, Cole and Weinbaum (2010) worked with networks built of connections between staff who went to each other for help; networks made of connections between staff formed by nonprofessional discussions, like relaxation or discussion of personal issues; and networks based on connections formed when a staff member recurred to another for help in implementing a given school reform program.

The L2 Context

Moral difficulty is found in many fields and, while it is pertinent to all branches of teaching, it is especially proximate to L2 classrooms. It must be emphasized that L2 teachers face not only all the typical MIEs encountered by all teachers, but their own MIEs particular to L2 teaching. Some MIEs are dramatically more common in L2 classrooms, as will be discussed in continuation. As if these were not enough, L2 teachers are still at-risk for all the MIEs that arise outside schools: the racism, discrimination, violence, and the like that exist within all societies. Moral distress, as it causes a breakdown of trust and confidence, will raise the affective filter between teacher and student. A student suffering moral distress tied to L2 culture cannot be expected to want to continue in language learning, just as a teacher under moral distress is far less able to meet their student’s needs.

Culture can be a flashpoint for MIEs. L2 classrooms are cultural contact points for both their teachers and students. Many L2 programs bridge majority-minority communities and involve all the moral challenges involved in bringing disparate (and sometimes hostile) communities together. Students, teachers, administrators, and parents may view the L2 or L2 culture as inferior, undesirable, or problematic. MIEs tied to cultural contact include bullying, classism, racism, and religious discrimination. This bridging runs both directions, as language majority students learn minority languages and language minority students learn majority languages. Substantive cultural exploration necessarily exposes moral differences between students, teachers, and the target culture. Teachers and students alike may be unprepared to handle those differences responsibly.

Consider the contextual variety of a concept like target culture. When a target culture is ostensibly faraway, learning its language becomes a problem of empathy, globalism, and international involvement. Closer to home, it is often the case that the target culture is the host culture, which implies a dangerous power dynamic that students and teachers must navigate. For instance, members of host cultures do not need to choose between their family’s cultural identity and an identity based on the host culture; for them, those cultures are the same. On the other hand, language and cultural minority students may be punished by their families for assimilating, while they may also be punished by peers for not assimilating. Those dueling pressures could well manifest as the student attempts to learn the L2.

Because so many L2 classrooms include individuals with immigrant, refugee, or other minority backgrounds, these individuals are more likely to suffer MIEs outside the classroom. Many refugees with profound, unresolved trauma. Students and teachers may have friends or family deported. They may be in danger of deportation themselves. Beyond deportation, there is a myriad of dangers and distractions found in navigating immigration law: document issues, court hearings, interviews. Even when a student belongs to a majority at home, they may discover that, in the target culture, they would belong to a minority suffering discrimination.

This contextual complexity creates moral complexity, increasing the risk of MIEs. MIEs suffered by teachers can affect students and vice versa. The fact that L2 students and teachers are at heightened risk for MIEs increases the risk their peers face, too. Thus, while all teachers are at risk for moral distress, moral distress is a particularly urgent issue in L2 teaching. Many of the same things that make L2 learning and teaching so valuable are the same things that create MIE risk. MIEs must be managed without sacrificing the cultural integrity of L2 classrooms.

A Model of Moral Distress

Current and previous conceptions of moral distress have repeatedly proven inadequate. (Devos Barlem & Souza Ramos, 2014; Bradbury-Jones et al., 2020). This inadequacy stems from several sources. One source is the variety of MIEs; as more MIEs are considered, the concept of moral distress is complicated and vice versa. Another is that moral distress is a young concept; it was first developed by the nursing field in the 1980s. Moral distress has been considered within pedagogy for only about a decade. In general, the movement has been towards a broader concept.

The concept began with this definition of an MIE: “one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action” (Jameton, 1984, as cited in Bradbury-Jones et al., 2020). Constraints, institutional or otherwise, are what allows an MIE to produce moral distress.

Moral distress exhibits a cyclical, self-perpetuating structure in the individual, as described by Devos Barlem and Souza Ramos (2014). See Figure I on the next page. An individual experiences something that causes them moral sensitivity, uncertainty, or discomfort. The subject typically will attempt to resolve the source of their moral issue, through processes like deliberation and advocacy (possibly self-advocacy, possibly advocacy on another’s behalf). Devos Barlem and Souza Ramos suggest that moral distress begins when these resolving processes are obstructed.

The concept of obstruction should be interpreted broadly. Some subjects may take no action to resolve their initial feelings of moral distress, especially if it is their own actions that are morally troubling. A person may simply violate their own conscience and make a habit of doing so. The obstruction here, is the self. A similar case is when the moral distress is attached to a past, irreversible action, in which case it is time itself that causes the obstruction. Shapira-Lishchinsky (2011) found several teachers whose moral distress stemmed from their own past misbehavior (in this case, moral distress begins to overlap with concepts like guilt and shame). Furthermore, the initial conditions—moral sensitivity, uncertainty, and discomfort—can constitute obstruction in themselves. If they manifest severely enough, they may produce decision paralysis. Abstractions, like ignorance, uncertainty, or self-doubt can also provide obstructions, preventing the subject from even attempting action. It should also not be assumed that the initial MIE is composed of a single problem—the obstruction may be that too many morally distressing events are happening at once to handle.

The obstruction tends to compound the initial feelings of moral distress. The experience of having someone or something prevent the subject from doing what they feel is right tends to be morally injurious itself. Thus, what may have been thought to be a simple, single MIE may in fact be a multi-faceted process of morally injurious experience.

Figure 1. Conceptual model of moral distress (Devos Barlem & Souza Ramos, 2014, p. 5)

After nonresolution occurs, the subject begins to suffer feelings of powerlessness. Feelings of powerlessness reduce the subject’s resistance and mortify their interest. All three of these factors mutually reinforce each other, forming what Devos Barlem and Souza Ramos refer to as the “Chain of Moral Distress” (2014, p. 5). The reduced resistance to MIE increases moral sensitivity, uncertainty, and discomfort (that is, it aggravates the original condition of moral distress). Reduced resistance also may cause the subject to fail in preventing additional MIEs. The mortification of personal interests produces ethical, political, and advocational inexpressivity. Ethical, political, and advocational expressivity are all tools for preventing and correcting MIEs, heightening the risk of new MIEs again. The chain collectively produces moral distress, with distinct physical, psychical, and behavioral symptoms.

By way of note, there is a strong tendency to associate moral distress with institutional obstruction. Devos Barlem and Souza Ramos frame moral distress as occurring because of institutional power games. This certainly captures many moral distress situations. Institutions are effective at suppressing moral expression. Employees, dependents, and the like are unlikely to raise moral objections to people who control their pay, employment, or other necessities. The subordinate status of the nurse in the nurse-doctor and nurse-hospital relationship likely explains why moral distress was first identified within the nursing field. Teachers and students often find themselves in potentially subordinate positions: adjunct-tenure professor, teacher-administrator, teacher-school, student-teacher, student-parent, student-student, student-school, and sometimes teacher-parent. Additionally, social norms often demand moral suppression. A moral critique directed at a coworker may be viewed as poisoning the workplace environment by introducing conflict. It may damage all of a person’s workplace relationships, not just the relationship with the person creating the MIE. It is hard to question someone’s moral activity, even in an agreeable fashion, if that person is unlikely to be receptive. The source of the MIE may be a bully who already punishes the victim arbitrarily and without consequence. These social issues are worse in workplaces with low turnover, like schools, where the social repercussions of speaking up can last years. It is often the case that institutions punish people for doing the right thing.

The institutional view does not, however, address moral distress that stems from events like when genuinely incompatible interests need to be accommodated or when it’s not a game of power but there is simply insufficient power available to all involved actors to achieve an unambiguously good moral result. Moral distress from failing to prevent violence or death, for instance, cannot be resolved in the sense that violence and death cannot be undone.

Moral distress, as described in the prior model, reinforces itself at several levels. It occurs within the process itself, as obstruction becomes an MIE itself and the Chain of Moral Distress makes the subject more vulnerable to new MIEs. However, one of moral distress’ most effective methods of self-preservation is on the level of the social network. Three phenomena cause moral distress to spread across a network: the cascading effects of the original MIE on the social network, the implicit reach of an MIE, and the damage moral distress causes to the connections that compose social networks.

Typically, MIEs have victims. Moral distress is a distinct phenomenon from victimhood, but often forms part of the experience of victimhood (Currier et al., 2015). Moral distress can affect everyone from the victim themself to remote witnesses, people who only hear of the morally problematic event. Moral distress starts with being troubled about a moral issue. The subject need not be directly affected by it in any way. This makes managing MIEs difficult, as the waves of harm tend to be diverse and possibly far-reaching. Moral distress causes harm even beyond what victimhood predicts (Currier et al., 2015).

The second effect is how MIEs can spread across healthy connections. Many important connections are implicit: if person A is connected to person B and person B is connected to person C, even though person A is not connected to person C, their shared bonds with person B can allow them to influence each other. Classic examples of these implicit connections are love triangles or the person in a trio who is stuck between two friends-turned-enemies. Implicit connections can be especially potent because they can force connections between people who do not want to be connected. If person A is victimized, person B is likely to be distressed. Assuming the victimization goes unresolved, persons A and B will likely develop moral distress. Even though person C is not connected to person A, they are likely to share person B’s distress. If the MIE is foul enough, merely learning about it may cause person C, and anyone else who hears it, to become morally distressed. Moral distress does not need a positive, trust-filled, or friendly connection to spread. A nasty enough idea hurts anyone who hears it, even if they are not connected to the actual sufferer.

The third social effect is that those suffering moral distress will have their social relationships decay. Mortification of interests cuts the subject off from healing hobbies and interest-based relationships. Many MIEs involve betrayal, on the individual or institutional level. People suffering moral distress will often lose faith in those who caused the MIE and those who failed to resolve it. Loss of trust destroys social connections. Loss of connections isolates the individual, increasing stress and cutting them off from any support systems that may still be operational. The more a person sought help and failed to receive it, the more pronounced this effect will be.

When individuals reach this point, this makes it incredibly difficult for the institution to correct its own problems. This is especially true if the institution is at fault. The success of school reforms depends massively on connections of trust (Moolenaar & Sleegers, 2010). Furthermore, schools where the average connections per individual was lower (referred to as low density) were less successful at implementing reform. Moral distress damages and deletes connections. Trust tends to be lower in surviving social connections and connection loss, besides isolating the individual, lowers network density. In other words, not only are they cut off from everyone else, everyone else is cut off from them. The isolated teacher will not be an effective advocate for reform, even if they are receptive to the reform, because they cannot transfer their positive feelings towards reform to others. There may be a temptation to artificially bring schools together in such circumstances by forcing staff to interact. This is unlikely to be successful. These networks need to be natural; artificial social connections established to encourage reform were ineffective at propagating change (Cole & Weinbaum, 2010). Whatever attitudes spread over natural social networks, pro-reform or anti-reform, would prevail over attitude spread across artificial social networks. Trust, friendship, and mutual support are essential for helping those facing MIEs. A school with a weak social network, whatever the cause, suffers a heightened risk of moral distress because it cannot provide that support. Once that moral distress takes root, it will self-perpetuate unless serious action is taken.

Discussion

A great deal of research on moral distress remains to be done. The field is young. However, some strong conclusions exist. First, preventing is better than curing. Due to the self-perpetuating nature of MIEs and moral distress, it is harder to cure than prevent. The unfortunate companion to this observation is that, on some level, moral distress is inevitable. If there were a school that managed to perfect its internal moral systems, it would exist within broader social institutions that would continue to produce moral distress. Teachers and students cannot always rely on police, child-protection agencies, parents, and governments to do the right thing. As teachers are increasingly placed on the frontline of childcare and as school resources remain critically insufficient, moral distress among teachers will rise. It is good for teachers to do good and to do the best they can, but these social changes are exposing more and more teachers to profoundly troubling MIEs. The situation is only worse in third-world countries; Currier et al., in both the 2014 and 2015 studies, examined El Salvador, where teachers’ students were being murdered and kidnapped by gangs at global-record heights.

Both prevention and curation are more effective at the institutional level. As institutional mismanagement produces moral distress, the absence of moral distress implies proper institutional management. Institutions designed with robust and supportive moral systems are powerful tools against moral distress, both in terms of prevention and treatment. Some such structures already exist. For instance, Löfstrom et al. (2018) found that the strong antiplagiarism institutions in universities shielded professors from moral distress caused by their students’ plagiarism. Of special mention is how, in effective programs, professors were given the option to take on as much of the issue as they felt comfortable with and offload the rest to another professor. The freedom to handle the situation on one’s own combined with the assurance that they do not have to do any more than they are comfortable handling (even if that amount is zero) is an effective balance between individual agency and mutual support. Institutional solutions should avoid dictating precise solutions or stripping individuals of their ability to choose what to do, because that is precisely how institutions cause MIEs. Guidelines, default recommendations, and the like allow the institution to set standards while preserving the balance so long as they do not become tyrannical. The balance is delicate; if individuals are too independent, they will cause their peers moral distress, but if they are too limited, they will be unable to do what is right themselves. Many institutions have programs like this for specific MIEs. In light of rapidly changing social and educational contexts, it remains to implement similar systems, when appropriate, for other MIEs.

The development of such programs remains an open question and will likely come with great contextual variety. A systematic approach to solution development could begin by studying known examples of MIEs, such as in Váchova (2019), Thornberg (2010), and Shapira-Lishchinsky (2011). Identifying the original sources of moral distress and obstructions can guide solutions. Which MIEs are better handled at the systemic level and which at the individual level is a question as well. Developing robust curative systems, like better moral distress diagnostic tools, as Váchova’s work attempts, and is another necessary element.

Prior research on combating moral distress has naturally emphasized the role of the sufferer within moral distress (see Currier et al., 2014; Devos Barlem & Souza Ramos, 2014). Once moral distress arises, the sufferer needs attention and should be treated. Possibly on account of its origins in the medical industry, moral distress is often framed as a condition to be treated, with the problem ending once the condition passes. Some remaining problems on this front include effective treatment, but especially diagnosis. Underdiagnosis is likely both because awareness of moral distress is low and because it is associated with better known conditions, like PTSD, burnout, and direct victimization. This research is essential for the curative function. However, this orientation towards the morally distressed is incomplete.

As discussed, institutions are often at the core of MIEs, whether as the obstruction or the source. Within the teaching profession, there are an abundance of power structures in which teachers are not able to morally advocate. The problems that existed guaranteeing MIEs inside and outside schools are also preventing teachers from fixing them. Teachers often lack negotiation power vis-à-vis administration, parents, peers, and even students, with little resources to address the broad swathe of social issues that appear within the schooling context. In the face of poverty, crime, discrimination, and the whole spectrum of childhood and teenage suffering, teachers are often powerless to address the actual problems they and their students face. This fact must be repeated. The issue will remain urgent without serious commitment to resourcing schools and other social institutions.

Hand-in-hand, moral distress among students must be studied further. The current research almost exclusively focuses on teachers. Nonetheless, Thornberg (2010), without using the vocabulary of moral distress, found an incredible rate of MIEs among students, all the way down to preschoolers. Significant institutional and social norms were already producing significant obstacles to students attempting to act according to their conscience.

Finally, moral distress within the L2 context is little understood. It is, so to speak, an elephant in the room. It goes without saying that classes centered around minority language speakers, cultural integration, globalized populations and the like are going to encounter MIEs. The moral component of culture shock, even if it disappears from students over time, is experienced by every new cohort. Cultural exploration is almost guaranteed inefficacy if it cannot address moral distress in its students, just as its efficacy will be greatly enhanced if moral distress is anticipated and addressed. It is worth asking whether prior MIEs are a significant reason why so much cultural activity in the L2 classroom is insubstantial. L2 classrooms can help immigrants and refugees find their place in new societies, just as they can help natives find their place in the global community. The chief obstruction here is, perhaps, the absence of moral thinking. Discussing foods, dances, and dresses is all well and good, but they are but a skeleton without the moral lifeblood of culture.

Conclusion

Moral thinking has the power to transform schools and society. As Thornberg (2010) concludes:

Moral development and education in … schools have to be far more proactive than merely making advances in moral reasoning and talking about hypothetical dilemmas indecontextualized classroom settings. Prosocial morality has to be practiced so that it can thereby become a significant part of students’ sense-making and actions in everyday real life. (p. 605)

L2 classrooms must be capable of meeting the moral challenges it invokes: those found by the host culture, those faced by the target culture, and those of the students themselves.

A world without moral distress is not a reasonable objective. It is fine for students to have morally difficult experiences. That is a part of moral growth and cultural discovery. The problem is that moral difficulty becomes moral injury. They find themselves alone, unsupported. What should have been one of a million moments in the slow growth of the human soul, a wound opens and is left to fester. The healing process, on the contrary, is the act of teaching itself: supporting a confused soul with the knowledge and resources they need to solve the problem themselves.

References

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