A reflection on moral distress in nursing together with a current application of the concept.

The concept of moral distress can be extended from clinical settings to larger environmental concerns affecting health care. Moral distress-a common experience in complex societies-arises when individuals have clear moral judgments about societal practices, but have difficulty in finding a venue in which to express concerns. Since health care is large in scale and climate change is proving to be a major environmental problem, scaling down health care is inevitably a necessary element for mitigating climate change. Because it is extremely challenging to discuss these concerns in health care settings, those concerned about climate change and health care experience distress. This article outlines some philosophical concepts and perspectives that may be useful in mitigating this distress.