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Moral Distress in Pediatric Palliative Care: Classic Problems and Challenges of the COVID-19 Pandemic
 
PIIS023620070020518-6-1
DOI10.31857/S023620070020518-6
Publication type Article
Status Published
Authors
Dmitry I. Nozdrachev 
Affiliation: Pirogov Russian National Research Medical University
Address: 1 Ostrovitjanova Str., Moscow 117997, Russian Federation
Kirill A. Zamyatin
Affiliation: Pirogov Russian National Research Medical University
Address: 1 Ostrovitjanova Str., Moscow 117997, Russian Federation
Maksim D. Miroshnichenko
Affiliation: Pirogov Russian National Research Medical University
Address: 1 Ostrovitjanova Str., Moscow 117997, Russian Federation
Journal nameChelovek
EditionVolume 33 Issue 3
Pages138-158
Abstract

Moral distress is an actual problem of medical ethics, psychology and healthcare. Its direct effects are the persistence of negative affect, emotional burnout, doctors leaving the profession; indirect damage from moral distress includes a significant worsening of medical care, a decrease in the quality of life of patients and physicians. Pediatric palliative care is a particularly sensitive area to moral distress, rich in severe, intractable existential and moral problems. The article examines the basic concepts of the nature of moral distress in medical care in general and palliative care for children in particular, and analyzes the structure of the experience of moral distress by healthcare professionals. Based on the data of modern psychometric and phenomenological studies, the causes of experiencing moral distress are identified and generalized. The phenomenon of moral distress among patients of palliative care for children and their family members, which has so far rarely been in the focus of researchers, is considered separately. The study of moral distress is based on the sometimes antagonistic interaction of two research paradigms — phenomenological, focused on the analysis of people's experiences and psychometric, objectified; their correlation and the possibility of integrating the results obtained into healthcare practice are also discussed in this article.

Keywordsmoral distress, palliative care for children, bioethics, medical ethics, pandemic, coronavirus infection, burnout
Received16.06.2022
Publication date24.06.2022
Number of characters34648
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