Moral distress among community pharmacists: causes and achievable remedies

Objectives This study aims to explore the incidence of moral distress experienced by UK community pharmacists through the deployment of a previously developed and validated survey instrument to a national sample. Methods An e-mail inviting pharmacists to complete an on-line questionnaire developed to measure moral distress was successfully delivered via the mailing list of a nationwide support organisation for the pharmacy profession. Completed questionnaires were subjected to statistical analysis to determine to what extent common practice scenarios generated moral distress in community pharmacists. Key findings Time constraints represent the greatest source of moral distress for United Kingdom (UK) community pharmacists, scoring highest for both frequency and intensity of distress. The supply of emergency hormonal contraception (EHC) in opposition to religious beliefs scored lowest. Possible underlying causes of moral distress are discussed in the light of our results, and potential mechanisms for reducing the incidence of moral distress for this professional group are considered. The reduction in the frequency and occurrence of moral distress is best achieved by the creation of morally habitable workplaces, where possible triggers can be identified and avoided. Structured undergraduate ethics education and accessible postgraduate training and resources could provide a meaningful opportunity to support pharmacists in exercising their moral competency or moral agency. Conclusions Moral distress provides a reliable indicator of constraints in the form of policies, legislation and regulations, and the structural and relational aspects of the working environment in which pharmacists practise. This provides invaluable information in the search for strategies to reduce the recurrence of this phenomenon.