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In a working environment where time pressures, technology and competition are increasingly threatening professionals, it is not difficult to conceive that stressors can impact our productivity and well-being. But while some limited amounts of stress can be healthy and enhance working performance, occupational stress that results from disparities between ethical values and expected behaviours – known as ethical stress – can have negative consequences for your health and well-being and even lead to burnout.

Ethical issues can occur in any situation where profound moral questions of what is ‘right’ or ‘wrong’ underlie professional decision-making. For example, do solicitors assume responsibility for the clients they represent? Should they represent clients they consider morally dubious? Many professionals are likely to ask themselves similar questions when they have to work in circumstances that compromise their professional ethics or conflict with their personal goals, values, or beliefs. Often, they may face loss of employment if they do not continue to work in these challenging contexts. Making ethical decisions, however, can be particularly challenging, as other people can be affected by the decisions we make. As a result, ethical decision-making can be both stressful and mentally draining.

Stressful professions

When professionals experience stress, this means that the demands being placed on them exceed the support and coping resources that they are able to mobilise.

Much of the work on ethical stress has occurred in the nursing and social work literature, probably due to the frequency of ethical and moral issues occurring in welfare-related work. Put simply, when one’s values and actions are at odds, this creates a specific kind of stress which can lead to dissatisfaction or even to leaving one’s employment. Ethical stress is thought to encompass two key components: dissonance and guilt.

While dissonance relates to the painful feelings of inauthenticity that individuals experience when their values and feelings do not align with their actions, guilt is experienced when it is not possible to act in accordance with one’s values. Ethical stress is accompanied by feelings of powerlessness and lack of control over a situation, and this lack of control regarding ethical behaviour has a number of implications for both the individual and the workplace.

According to the psychological literature, three factors determine the nature of ethical issues and the ways in which these are perceived and addressed:

• The person’s position or role in the organisation
• The resources or support available to address ethical dilemmas
• The sources of (dis)satisfaction within the work environment.

Indeed, the person’s role determines the degree to which they are involved in ethical decision-making and moral action; the availability of peers and ethics committees enables important consultations and discussions to take place; and individual factors such as self-motivation or strong working relationships are powerful sources of job satisfaction.

These factors are linked and, together, they can be said to influence ethical stress. For example, if there is a positive ethical climate within an institution and individuals have access to mentors to discuss ethical issues, it is likely that they will feel involved in the decision-making process and be in a better position to take moral action when needed. In turn, this may impact positively on their self-confidence and career satisfaction. A negative ethical climate, however, will engender ethical stress, and make it less likely that moral action is taken. It will also lead to frustration.

Moral injury

While there are cases when dissonance can eventually lead to greater professional and personal growth, value collisions can also be a source of great psychological pain.

In fact, when professionals have to work in conditions where they need to compromise their ethical or moral convictions, this can provoke ‘moral injury’. Moral injury tends to happen when there are sustained managerial, formulaic and procedural expectations that constrain or inhibit value-based, responsive practice. People are more likely to experience ethical stress and moral injury when they work in a rigid system where there is little opportunity to voice concerns or to discuss ethical decisions with other involved parties. This leads to an emphasis on making defensible decisions, and creates a risk-averse climate where individuals are encouraged to look after their own interests.

Employees need to work in frameworks that value different perspectives, a flexible and positive view of risk-taking, and that enable relationship building with the different parties involved. Excessively bureaucratic, defensive, and procedural environments seem to be where ethical stress and moral injury thrive. Taken to the extreme, experiencing ethical stress and moral injury repeatedly can result in altered beliefs about the world and the self, deteriorate character, and impair capacity for trust. The risks associated with ethical stress and moral injury also include vicarious trauma and burnout.

Of course, individual factors can influence the occurrence of ethical stress, such as one’s levels of resilience or prior experiences, and situations of ethical stress do not always result in burnout. Nevertheless, given certain conditions, it is clear that some professionals can be particularly vulnerable, and we currently don’t know enough about the various ways in which people can be psychologically impacted by their work.

What is clear, however, is that educators, employers, and professional associations have a duty-of-care when it comes to supporting employees. In some professions such as nursing, there is a need to become self-aware and workers need guidance when it comes to attending to their own emotional, spiritual, psychological and physical needs; they need to be taught preventive measures to manage their stress, and solutions for processing challenging ethical experiences. I would even argue that the provision of positive support for ethical reflection is an occupational health and safety issue for many professionals.

Séverine Hubscher-Davidson, PhD is an academic and freelance writer based in Milton Keynes in Buckinghamshire.