It is widely known that veterans can return from war with Post-Traumatic Stress Disorder (PTSD). Far less appreciated is moral injury – a trauma wrapped up in guilt that we are now learning more about thanks to US-based research, writes James Jeffrey.
Moral injury most often occurs when a person commits, fails to prevent or witnesses an act that is anathema to their moral beliefs.
The Department of Veterans Affairs website likens it to psychological trauma involving “extreme and unprecedented life experience”, that can lead to “haunting states of inner conflict and turmoil”.
US-based research into moral injury is now illuminating how such injuries can impact people in all walks of life, but especially first responders and healthcare workers facing the Covid-19 coronavirus outbreak.
Amid reports of New York City’s emergency services getting overwhelmed and states struggling to provide enough ventilators, first responders and healthcare workers potentially face having to decide who gets a ventilator and who gets saved – something one nurse has described as “her biggest fear”.
Already thousands are dying in their care – and medical workers say they are facing scenarios they had never anticipated.
One doctor told the BBC the stress was intense. “Seeing people die is not the issue. We’re trained to deal with death… The issue is giving up on people we wouldn’t normally give up on.”
Arthur Markman, a professor in the department of psychology at the University of Texas at Austin, says: “Few people in healthcare have had real-life experience with triage in which a significant number of life-and-death decisions had to be made because of equipment shortages. That increases the chances that they may experience moral injury as a result of their jobs.”