Jonathan Moens
The Atlantic
Originally posted 8 June 21
Here is an excerpt:
The core features of moral injury are feelings of betrayal by colleagues, leaders, and institutions who forced people into moral quandaries, says Suzanne Shale, a medical ethicist. As a way to minimize exposure for the entire team, Kathleen Turner and other ICU nurses have had to take on multiple roles: cleaning rooms, conducting blood tests, running neurological exams, and standing in for families who can’t keep patients company. Juggling all those tasks has left Turner feeling abandoned and expendable. “It definitely exposes and highlights the power dynamics within health care of who gets to say ‘No, I'm too high risk; I can't go in that patient's room,’” she said. Kate Dupuis, a clinical neuropsychiatrist and researcher at Canada’s Sheridan College, also felt her moral foundations shaken after Ontario’s decision to shut down schools for in-person learning at the start of the pandemic. The closures have left her worrying about the potential mental-health consequences this will have on her children.
For some people dealing with moral injury right now, the future might hold what is known as “post-traumatic growth,” whereby people’s sense of purpose is reinforced during adverse events, says Victoria Williamson, a researcher who studies moral injury at Oxford University and King’s College London. Last spring, Ahmed Ali, an imam in Brooklyn, New York, felt his moral code violated when dead bodies that were sent to him to perform religious rituals were improperly handled and had blood spilling from detached IV tubes. The experience has invigorated his dedication to helping others in the name of God. “That was a spiritual feeling,” he said.
But moral injury may leave other people feeling befuddled and searching for some way to make sense of a very bad year. If moral injury is left unaddressed, Greenberg said, there’s a real risk that people will develop depression, alcohol misuse, and suicidality. People suffering from moral injury risk retreating into isolation, engaging in self-destructive behaviors, and disconnecting from their friends and family. In the U.K., moral injury among military veterans has been linked to a loss of faith in organized religion. The psychological cost of a traumatic event is largely determined by what happens afterward, meaning that a lack of support from family, friends, and experts who can help people process these events—now that some of us are clawing our way out of the pandemic—could have serious mental-health repercussions. “This phase that we’re in now is actually the phase that’s the most important,” Greenberg said.
