How can I even think about morals when I have a bladder the size of a space hopper?

Columnist Dr Copperfield responds to a survey that found that GPs have suffered from moral distress after being unable to provide the care they wanted to deliver

Morally distressed? There’s an 80% chance you are. Because, according to research conducted by the MDDUS, nearly four in five GPs experience ‘moral distress’ while looking after patients.

I wasn’t entirely sure what ‘moral distress’ was, which I found distressing. So I looked it up and discovered that it’s about being emotionally burdened by an inability to provide the care we feel we should be able to deliver, aka being pissed off by the NHS.

But that’s hardly new, is it? So presumably ‘moral distress’ is the ‘sepsis’ of the GP psyche – ie, something that’s always existed but has been given new legitimacy and urgency thanks to a fancy new name. And if you think ‘distress’ comes nowhere near describing the torment you feel on behalf of your patients, then you’re probably suffering from the more severe ‘moral injury’, another neologism whereby, I’m guessing, your anguished teeth-gnashing literally dislocates your jaw.

In truth, we suffer many forms of hurt in our day job, and I’m not sure that the moral one is the most profound. You’ll have your own candidates, but for me, at least in winter, it’s the intellectual and microbiological distress of having to deal with surgeries full of manifestly well, mildly viral patients who wreak revenge on my refusal to prescribe antibiotics by deliberately coughing a fusillade of phlegmy droplets in my face. Which only just shades the urological distress caused by the workload of those sessions not allowing me to have a pee.

Besides, ironically, the current parlous state of the NHS actually eases the moral pain for us GPs. Previously, we went through the pantomime of referral etc with patients who truly believed we were going to achieve something for them, which did create a tension. Now, both we and they know that their referral will disappear into a mysterious black hole, or that any appointment will only appear after they are better, dead, or have gone privately.

So there is no longer any sense of deception and any feeling of moral distress is therefore replaced by mutual apathetic fatalism. Perhaps I should suggest to the MDDUS that they measure that, except that I can’t be bothered and I know what the outcome would be anyway.

Dr Copperfield is a GP in Essex. Read more of his blogs here