A significant proportion of doctors in the UK are feeling "distressed" because they cannot give patients the care they would like, leading medics have warned.
What is moral distress and moral injury?
Moral distress can be understood as the feeling of unease stemming from being unable to undertake an ethically correct action due to institutional or resource constraints, the BMA said.
For example, a doctor may suffer moral distress if they feel they cannot give their patient as high a level of care as they would like due to their high workload or due to a lack of resources.
Meanwhile, moral injury can arise where sustained moral distress leads to impaired function or longer-term psychological harm.
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A new BMA poll of almost 2,000 doctors found that the concepts of moral distress and moral injury were new to many medics, but more than three-quarters (78.4%) of respondents stated that moral distress resonated with their experiences at work.
Over half of doctors cited “insufficient staffing to suitably treat all patients” as one of the leading causes of their moral distress.
Mental fatigue was the second most common reason.
A “lack of time to provide adequate emotional support to patients” and an “inability to provide timely treatment” were both cited as the third leading causes, the BMA said.
The doctors’ union found that some medics are also suffering from the longer-term psychological harm associated with moral injury.
The poll found that 51% of respondents reported that moral injury resonated with their experiences at work.
Dr Helen Fidler, deputy chair of the BMA consultants committee, said: “The results of this research are, without doubt, incredibly worrying.
“As with many pre-existing pressures on staff in the NHS, the Covid-19 pandemic has only exacerbated moral distress and moral injury.
“Doctors have less autonomy, government support has failed to keep up with patient demand, and we’re now at the point where these pressures are driving talented professionals to breaking point, with many staff even leaving the health service because of it
“All doctors want to do is to help others – it’s why we’re in this job – but when we’re unable to make decisions that we believe are ethically right, it’s not only distressing, but also goes against every fibre of who we are: it’s entrapping, stifling, and directly impacts the care we give to our patients.”
Prerana Issar, chief people officer for the NHS, said: “The NHS has provided care for Covid to everyone who would have benefited from it, throughout the pandemic, and the response of NHS staff who cared for 400,000 seriously ill Covid patients in hospital, has been truly extraordinary.
“It is absolutely right that staff are also well supported and cared for which is why there is help and advice available, backed by an additional £15 million of investment and including a confidential advice line, 24/7 text support and access to mental health services.”