Most UK doctors experiencing moral distress, survey shows

    Nearly four out of five (78%) family doctors across the United Kingdom are experiencing moral distress while caring for their patients.

    New research conducted by the medical defence organisation MDDUS revealed that doctors are emotionally burdened from being unable to provide the care they want and expect to deliver due to issues such as lack of resources and delays. 

    Moral distress occurs when the gap between what professional judgment dictates should be done and what the healthcare system currently permits is wide.

    Among doctors as a whole working in hospitals and GP practices, 65% said they had experienced moral distress while working in the NHS. 

    Of doctors who said they were experiencing moral distress 83%, said it was due to the current challenges facing the NHS. 

    The impact of the cost-of-living crisis is also contributing to this distress, with 65% of doctors saying that patients are presenting with conditions that are preventable through better diet and living conditions. 

    The most prevalent are new severe psychological problems, with 76% of doctors saying they’ve encountered this. Doctors have also seen an increase in the Victorian-era illness scurvy (14%).

    The impact of the cost-of-living conditions on children’s health has particularly affected doctors. One said their patients were in “inappropriate housing that was unsanitary and unsafe for a toddler”.

    Another described treating “unkempt children with poor fitting shoes causing blistering and sores”.

    Other preventable and treatable conditions doctors said they have come across included:  

    • Asthma (53%)
    • Folate deficiency (46%)  
    • Other vitamin deficiency (50%)  

    The findings have also highlighted the impact moral distress could have on the retention of NHS doctors, with 40% saying they have considered leaving the medical profession altogether or retiring early due to the burden.

    MDDUS also asked questions about being unhappy at work to explore how doctors’ feelings about this impacted their personal lives.

    Of the doctors who said their moral distress was due to the current challenges facing the NHS, 70% reported feeling unhappy at work, which led to trouble sleeping at night. A further 53% said they were having more arguments with friends and family.

    Meanwhile, 81% of doctors struggling with moral distress due to the challenges facing the NHS said their unhappiness at work was affecting their mental health, and 74% said they were concerned that their unhappiness could have a detrimental impact on their safe practice.

    Doctors told MDDUS: 

    • “Asking patients to choose between a prescription or heating causes me moral distress.”
    • “Patients (particularly the elderly) lined up on trolleys along corridors asking for help when you walk past is probably the thing that distresses me most about work at the moment.”
    • “Years of underfunding in NHS, not enough healthcare professionals and poor mental health services causes me moral distress.”
    • “Patients who can afford to go privately are able to quickly access multiple services and will likely have much better health outcomes. This is due to both cost of living crisis and lack of resources in the NHS.”
    • “I work in a deprived community who faced all the problems described before the cost-of-living crisis and impact of the pandemic. It is worse now, and those at the margins (and beyond) of poverty previously, are now facing the pre-existing problems faced by the poorest patients.”

    Dr John Holden, Chief Medical Officer, MDDUS, said:

    "These findings tell us that a wholly unacceptable number of doctors - almost two in three - have experienced moral distress due to the cost-of-living crisis and the challenges facing the NHS.

    "Being a doctor can, and should, be one of the most fulfilling jobs in the world. But right now, the scale of the pressure on the healthcare system is preventing doctors from being able to care for their patients the way they want to.

    "The results reveal the full extent of the psychological damage a worryingly large number of doctors experience because of problems they encounter in their working lives that they feel powerless to fix.

    "The range of issues doctors face as a byproduct of their moral distress is extensive, including anger, sadness, insomnia, relationship difficulties and more. And what's most concerning is how this can impact doctors' safe practice.

    "The situations facing patients that frequently trigger feelings of moral distress in doctors include waiting times, lack of beds, understaffing and having to practice medicine not to professional standards due to system constraints.

    "This research paints an alarming picture of the impact on both doctors' professional practice and personal wellbeing.

    "The emotional toll of moral distress should not be downplayed, as it has the capability to erode the morale and resilience in already overburdened doctors.

    "With an NHS staffing crisis ongoing, we absolutely cannot afford to lose any of our highly skilled doctors.

    "Our healthcare system needs adequate funding and resources to be able to provide the care patients deserve.

    “Doctors also need to feel empowered to speak up and challenge issues.”





    The Medical and Dental Defence Union of Scotland (MDDUS) is a mutual organisation that protects the professional interests of more than 56,000 doctors and dentists across the United Kingdom, offering access to indemnity, support and legal advice.


    Moral distress is defined as the psychological unease generated when professionals identify an ethically correct action to take but are constrained in their ability to take that action. 


    Sustained moral distress can lead to moral injury – a psychological trauma linked to mental health conditions, including depression and post-traumatic stress disorder (PTSD). 


    The survey questioned more than 2,000 healthcare professional members across the UK.

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