Another Pandemic

How moral distress affected Polish and Lithuanian clinicians




SARS-CoV-2 pandemic, toxic sociomoral atmosphere, healthcare ecology, moral distress, differences in levels of moral distress between Polish and Lithuanian medical workers, resiliency


The SARS-CoV-2 pandemic has transgressed biomedical categories. According to Horton, it turned out to be a 'syndrome' that infected virtually all spheres of social life. The pandemic has created toxic social atmosphere highly unfavorable to clinical and clinic-ethical decision making. Constraints and pressures related to micro-, meso-, exo- and macro-environments framing doctors, nurses, and medical students in training were identified. These factors exacerbated moral distress (moral injury) amongst clinicians. In a joint Polish-Lithuanian project (IDUB 2020-2022) we examined predictors of moral distress in pandemic clinical contexts. A survey-based, real-time, correlational and comparative study was conducted in Poland and Lithuania after the first year of pandemic with N=227 participants. Unexpected differences on regular and pandemic-type moral distress levels were found between the two national samples. Polish participants showed significantly higher moral distress levels than their Lithuanian counterparts. The following article discusses these findings and recommends the reinforcement of resilient medical decision making.   

Author Biographies

Ewa Nowak, Adam Mickiewicz University of Poznan

Full Professor, PhD, habil., Chair of Ethics, Adam Mickiewicz University, Poznań, Poland

Anna-Maria Barciszewska

Associate Prof. MD PhD, Dept. of Neurosurgery and Neurotraumatology, Karol Marcinkowski University of Medical Sciences,  Poznań, Poland

Roma Kriaučiūnienė

Prof. PhD, Dean, Dept. of Philology, Vilnius University, Lithuania

Agnė Jakavonytė-Akstinienė

MD, Dept. of Nursing, Vilnius University, Lithuania

Karolina Napiwodzka

Doctoral Candidate, Dept. of Philosophy, Adam Mickiewicz University, Poznań, Poland

Paweł Mazur

PhD, MA in law, Dept. of Philosophy, Adam Mickiewicz University, Poznań, Poland

Marina Klimenko

Associate Professor, Dr. Psy., Dept. of Psychology, University of Florida, Gainesville, USA

Clara Owen

PhD, Dept. of Psychology, University of Huddersfield, United Kingdom


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2023-03-21 — Updated on 2023-04-17

How to Cite

Nowak, E., Barciszewska, A.-M., Kriaučiūnienė, R., Jakavonytė-Akstinienė, A., Napiwodzka, K., Mazur, P., Klimenko, M. and Owen, C. (2023) “Another Pandemic : How moral distress affected Polish and Lithuanian clinicians ”, De Ethica, 7(2), pp. 3–27. doi: 10.3384/de-ethica.2001-8819.23723.