Moral distress and injury in the public health workforce and implications for policy and practice
1
European Public Health Association, Utrecht, Netherlands
2
Faculty of Public Health, London, United Kingdom
3
Global Network for Academic Public Health, Washington, United States
4
University of Applied Sciences, Emden / Leer, Germany
5
The World Federation of Public Health Associations, Geneva, Switzerland
6
Centre for Developmental and complex trauma, St Andrews Health Care, Northampton, United Kingdom
7
Kamuzu University of Health Sciences (KUHeS), Blantyre, Malawi
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
The concepts of moral distress and injury were originally described among soldiers during wars, law enforcement agents, and nurses, with growing interest in other health professionals. Public health professionals routinely face tough ethical decisions and morally ambiguous situations, and are vulnerable to moral distress and injury.
METHODS:
During the covid pandemic the Faculty of Public Health in collaboration with the European Public Health Association, University College London carried out a cross sectional survey of the public health workforce and collaborated with other partners to advance the agenda. There has been consideration of definitions, prevalence, nature, frequency, severity and impact of moral distress in the health professional workforce, and implication for prevention and care.
RESULTS:
The purpose of this workshop is to consider definitions, nature and impact; and findings and recommendations from their major scoping umbrella review of the published literature for a WHO. The workshop will also share the FPH workforce wellbeing initiative and ethics educational initiatives to support the health and wellbeing of its members. The FPH survey found that 64% of the public health workforce had one or more experiences of moral distress associated with their own action (or inaction), and 26% reported experiencing moral distress associated with a colleague’s or organization’s action (or inaction), and that 14% of those with moral distress, reported moral injury severe enough to require time off work and/or therapeutic help. The main situations resulting in moral distress included developing or implementing national policy, guidance and law, providing public health advice, and workplace relationships and environments. The scoping review noted significant limitations in the current studies and need for research in LMIC.
CONCLUSIONS:
Moral distress and injury are a significant issue in health workforce. Institutional and organisational aggravating factors are of particular importance and their implications to workforce policies.
The concepts of moral distress and injury were originally described among soldiers during wars, law enforcement agents, and nurses, with growing interest in other health professionals. Public health professionals routinely face tough ethical decisions and morally ambiguous situations, and are vulnerable to moral distress and injury.
METHODS:
During the covid pandemic the Faculty of Public Health in collaboration with the European Public Health Association, University College London carried out a cross sectional survey of the public health workforce and collaborated with other partners to advance the agenda. There has been consideration of definitions, prevalence, nature, frequency, severity and impact of moral distress in the health professional workforce, and implication for prevention and care.
RESULTS:
The purpose of this workshop is to consider definitions, nature and impact; and findings and recommendations from their major scoping umbrella review of the published literature for a WHO. The workshop will also share the FPH workforce wellbeing initiative and ethics educational initiatives to support the health and wellbeing of its members. The FPH survey found that 64% of the public health workforce had one or more experiences of moral distress associated with their own action (or inaction), and 26% reported experiencing moral distress associated with a colleague’s or organization’s action (or inaction), and that 14% of those with moral distress, reported moral injury severe enough to require time off work and/or therapeutic help. The main situations resulting in moral distress included developing or implementing national policy, guidance and law, providing public health advice, and workplace relationships and environments. The scoping review noted significant limitations in the current studies and need for research in LMIC.
CONCLUSIONS:
Moral distress and injury are a significant issue in health workforce. Institutional and organisational aggravating factors are of particular importance and their implications to workforce policies.
| eISSN: | 2654-1459 |
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