Firstov Stepan



Physician, Politician, Social Activist, Associate Member of the World Medical Association

«The most important condition to implement the human right to health is professionally skilled and responsible for their work physicians. To protect a physician means to protect a patient.»

Stepan Firstov

Home News The international community is concerned about the issue of moral distress in healthcare professions

The international community is concerned about the issue of moral distress in healthcare professions

10 December 2021

The international event titled online seminar «Moral distress in healthcare professions: theoretical and methodological perspectives» was held on December 2, 2021. Stepan Firstov, the Presidium member of the All-Russian public organization Society of doctors of Russia and Associate Member of the World Medical Association, received an invitation from the Pontifical Academy for Life in Vatican. The discussion was attended by a doctor of humanitarian, a diocesan priest and scientific director of the Lanza Foundation, a researcher of medical ethics in palliative care, a specialist in bioethics, etc.

The presentation of each speaker started with a small historical reference and moral disorder characteristics. This phenomenon had been investigated since the second half of the 20th century. Thus, moral disorder is a situation, in which a clinical decision is made, but the process of its implementation is difficult due to some functional, departmental, administrative or technical reasons. When experiencing a moral disorder, the deepest feelings of a person are attached. Furthermore, it can be protracted, which leads to a «crescendo effect». Every time the moral disorder arises and passes, but the level of residual moral disorder only increases and leads to professional burnout. It is recognized, that such phenomenon has a detrimental effect on the Healthcare system.

Many experts suggest to separate the decision-making procedure from the provision of clinical care. All decisions are to be made by the members of the special committee in order to avoid moral pressure of doctors and preserve the legal aspect of the doctor/patient relationship. From another point, it is necessary to learn true reasons of the origin of the phenomenon and structure them. For example, poor work team cooperation, poor ethical climate as well as the lack of discussions of ethical situations affect the professionals. Time should be found for ethical consultations inside medical facilities and psychological consultations. It is important to think up workload situations and practically implement them only from a teaching point of view, educate medical ethics and ethical principles and improve moral reasoning skills. No doubt, the Healthcare system cannot function well without state authorities and approval of special legislative norms.

The pandemic clearer highlighted the phenomenon of the moral disorder. The Healthcare systems require urgent attention of as many participant and stakeholders as possible. It needs its modernization by joint efforts, cooperative development of new approaches for staff as well as patients.