The causes and consequences of the ethical burden of those working in elderly care services, and especially the investigated solutions to reduce the ethical burden, seem to be a rather unexplored topic. Only 14 international research articles on ethical burden were found in the systematic study carried out by the Finnish Institute of Occupational Health’s Hyvä veto project.
Most of the articles were published in 2019 and 2020, which nevertheless suggests that there is a growing interest in the topic. There is good reason for the interest, because ethical burden is – especially together with other burden factors – a significant factor connected with decreased work ability.
Ethical burden is already unstable and difficult as a term. Five of the publications even came up with their own definitions for the term, and one did not define it at all.
Both causes and consequences in four different categories
A total of 53 causes and 21 consequences of ethical burden were found in the publications. In the survey, both causes and consequences were divided into four categories.
Causes of ethical burden
1. Organisational constraints of the workplace
2. Challenges related to personal and power relations
3. Challenges related to patient care
4. Employees’ feelings of incompetence and insecurity
Of the causes, the organisational constraints of the workplace were the most commonly studied.
Consequences of ethical burden
1. Absence from work
2. Mental health problems
3. Unhealthy and asocial lifestyles
4. Physical symptoms
None of the publications tried to solve the problems of ethical burden, though in three publications, support and training from the employer’s side, support from colleagues, development of competence and self-care as well as defence of patients’ rights were suggested as means to curb the burden. It was not possible to measure ethical burden in the publications in any consistent way either.
Further research is needed
There is an urgent need for further research on the causes and consequences of ethical burden, which can be used to increase the attractiveness of work in elderly care services that is already struggling with labour shortage and to extend the working careers of those working in the field. In addition to the mostly qualitative research found in the survey, quantitative research and long-term intervention research are also needed to develop solutions.
In Finland, the ethical burden is studied in the Hyvä Veto project of the Finnish Institute of Occupational Health, titled Ensuring the availability of staff and the attractiveness of the sector in elderly care services (Hyvä veto), which implements the national age programme.
Read the whole survey:
Risto Nikunlaakso, Kirsikka Selander, Elina Weiste, Eveliina Korkiakangas, Maria Paavolainen, Tiina Koivisto and Jaana Laitinen:
Understanding Moral Distress among Eldercare Workers: A Scoping Review
International Journal of Environmental Research and Public Health 2022
Kirsikka Selander, Risto Nikunlaakso, Jaana Laitinen
Association between work ability and work stressors: cross-sectional survey of elderly services and health and social care service employees
National Library of Medicine 2022
Eettinen kuormitus työssä – kymmenen kysymystä ja vastausta (Työpiste article)
Eettinen kuormitus keskusteluun sote-alalla (Blog of the Finnish Institute of Occupational Health)