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Covid-19 has amplified moral distress in medicine

BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n28 (Published 08 January 2021) Cite this as: BMJ 2021;372:n28

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  1. Julian Sheather, specialist adviser on ethics and human rights,
  2. Helen Fidler, deputy chair of UK Consultants Committee
  1. BMA, London, UK
  1. JSheather{at}bma.org.uk

Simply working harder cannot resolve the conflicts caused by responsibility without autonomy

Doctors are accustomed to difficulty, to long hours, high stress, heavy responsibility. The job involves helping people navigate life’s gravest challenges: death and dying, suffering, loss, and grief. It can regularly require tough life-altering decisions in the face of uncertainty. Such challenges are far from trivial. For as long as there have been healers though, this has been part of the territory.

Challenges well met can also bring rewards—they are linked to the satisfactions of medicine. But as the profession draws deeply on its resources to respond to covid-19, a new concept is entering the mainstream: moral distress.12 And it is shining a light on the deepening structural afflictions of medicine in the UK, problems that predated covid and, unless they are resolved, will endure long beyond it.

Moral distress is a psychological harm arising when people are forced to make, or witness, decisions or actions that contradict their core moral values. While exposure to the suffering of …

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