This exploratory, qualitative research explored the ethical problems faced by hospital social workers in South Korea and Australia, and what and who influenced their decision making using a focus group design. Although dilemmas of boundaries, confidentiality, self-determination, and other complex scenarios found in practice were identified, moral distress, a consequence of the unresolvable conflicts, dominated participants’ narratives. This was particularly the case for the Korean social workers in this sample. A thematic analysis of the data yielded three main themes: ‘Under pressure—“It’s very uncomfortable”’; ‘Failing our patients’; and ‘Coping and codes’.