It examines an embodied ethical orientation grounded in attentiveness, dignity, and wonder. Moral distress is reframed from a professional, psychological-moral weakness to moral possibility through attunement and shared vulnerability. The experience of moral distress can indicate that something a person or community normatively values - their integrity, relationships, or commitments - is under pressure, though the significance of that signal requires further interpretation and justification.

I seek to emphasize dying as a relational event that illuminates what it means to be human, while at the same time remains a mystery to many. This dissertation treats encounters with the dying mainly as moments to engage with the mystery of human experience.

In apophatic inquiry, mystery refers to aspects of lived experience that cannot be fully captured through language but may be approached through receptivity, silence, and wonder (Visse et al. 7-8). Human consciousness may make the event of death a reflection of the life once lived (Kokosalakis 404). Death care, even in silence, becomes an act of nurturing dignity, while presence and wonder can become forms of knowing and healing.

Part I, Grounding, establishes the importance of this work through its methodological framing and the compelling story of my hospice patient, Althea (a pseudonym), whose palliative sedation raised profound questions about informed consent, causing me to experience moral distress.

Part II, Knowing, engages the literature through Martin Buber's I–Thou philosophy of dialogue and feminist care ethics theory to demonstrate that dignity and autonomy emerge not from independence but from mutual recognition; the dialogical encounter in which nurse and dying patient meet as whole beings. Here, I challenge the dominance of individualistic autonomy in biomedical ethics, which too often abstracts reason from relationship.

Part III, Unknowing, returns to Althea's case as I unfold my experience of moral distress through the triad of apophatic spaces: the inner, the aesthetic, and the wondrous. Through and between these spaces I reflect on silence, vulnerability, and wonder as ethical ways of knowing, or unknowing, without "imposing ourselves" on what confronts us (Visse et al. 5). The aesthetic space includes my original artwork, which serves as a form of reflective engagement with my experience of moral distress. These images do not seek to illustrate the narrative but to remain present with what resists articulation. In this way, the unspeakable becomes a teacher, and the moral wound is allowed to reopen into deeper compassion and understanding.

Part IV, Unfolding, draws on Curt Cloninger's understanding of apophatic visual practices in Some Ways of Making Nothing: Apophatic Apparatuses in Contemporary Art (2021). While the artwork itself appears in Part III as part of the apophatic inquiry, this fourth section reflects on how that process allowed the experience of moral distress to be engaged rather than rushing to resolve it too quickly. Through this process, my inquiry gradually shifts from description toward unfolding, allowing meaning to emerge.