Moral Distress in Pediatric Palliative Care: Classic Problems and Challenges of the COVID-19 Pandemic

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.