2024-02-09 10:43:04
At a time when light is being shed on the numerous departures of caregivers, a consequence among other things of the moral crisis that the public hospital is going through, the Espace de Réflexion Ethique Bourgogne – Franche-Comté has chosen to take an interest in a report the foundations of doctors’ commitment to the public hospital service. Why did these doctors join the public hospital? What are the public service values central to their commitment and how are they manifested in their exercise?
Conclusion of this study:
This study highlights the way in which doctors have constructed themselves: their identity foundations, strongly charged with personal values oriented towards others (care, the desire to treat, to be useful to the sick, to relieve suffering, to devote oneself , etc.), transmitted through the family and professionally, have found a suitable framework within the public hospital service and would be the vector of their commitment.
However, the different ethical tensions emerging from the public institution seem to unbalance their commitment. T2A, budget cuts, lack of staff and beds, decision-making powerlessness, prevent doctors from practicing medicine as they would like, that is to say treating each individual without being interested in their status or their income. Rather than worrying solely regarding the care of their patients, doctors find themselves faced with thinking in terms of costs, budget, possibilities in the face of the lack of resources made available by the public hospital, even though they are not involved in decisions of this order. Added to this, the permanent lack of compensation, embodied by a reduction or even an absence of recognition on the part of the institution and patients, increases the feeling of constraint and arduousness. These constraints, often suffered, in turn generate personal suffering. This adds to the heavy emotional burdens that doctors face on a daily basis in their practices, thus increasing the psychological vulnerability factors and associated psychosocial risks to which they are exposed.
In the case of the suffering of caregivers, we can speak of moral distress, defined as “a psychological imbalance that can threaten the moral and physical integrity of a person and cause negative effects, such as disinvestment, a reduction in the ability to adapt, difficulty managing emotions, professional burnout and of depersonalization.” This suffering, when suffered for a prolonged period, tends to weaken the commitment of health professionals to the public hospital service.
Leave or stay? The wavering of doctors’ commitment to the public hospital service, Report from the Espace de Réflexion Ethique Bourgogne – Franche-Comté, February 1, 2024
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