Moral Injury During the CDOVID-19 Pandemic

Borges LM, Barnes SM,  et al. 

Psychol Trauma. 2020 Aug;12(S1):S138-S140. 

doi: 10.1037/tra0000698. Epub 2020 Jun 4. PMID: 32496101.

Here is an excerpt:

Moral injury in COVID-19 may be related to, but is distinct from: 1) burnout, 2) adjustment disorders, 3)

depression, 4) traumatic stress/PTSD, 5) moral injury in the military, and 6) moral distress. Moral injury

may be a contributing factor to burnout, adjustment disorders, or depression, but they are not equivalent. The diagnosis of PTSD requires a qualifying exposure to a traumatic stressor, whereas experiencing a moral injury does not. Moral injury in the military has been addressed in a different population and particularly after deployment, and its lessons may not be generalizable to moral injury during COVID-19, which we are seeing acutely among healthcare workers. Finally, moral distress may be a precursor to moral injury, but the terms are not interchangeable. Previous literature has noted that moral distress signals a need for systemic change because it is generated by systemic issues. Thus, moral distress can serve as a guide for healthcare improvement, and rapid systemic interventions to address moral distress may help to prevent and mitigate the impact of moral injury.

While not a mental disorder itself, moral injury undermines core capacities for well-being, including a

sense of ongoing value-laden actions, competence to face and meet challenges, and feelings of belonging and meaning. Moral injury is associated with strong feelings of shame and guilt and with intense self-condemnation and a shattered core sense of self. Clinical observations suggest that uncertainty in decision-making may increase the likelihood or intensity of moral injury.

In the context of a public health disaster such as the COVID-19 pandemic, acknowledgement of the need

to transition from ordinary standards of care to crisis standards of care can be both necessary and helpful to 1) provide a framework upon which to make difficult and ethically fraught decisions and 2) alleviate some of moral distress and indeed moral injury that may otherwise be experienced in the absence of such guidance. The pandemic forces us to confront challenging questions for which there are no clear answers, and to make “lose-lose” choices in which no one involved ends up feeling satisfied or even comfortable. 

The info is here.

This doctor is recruiting an army of medical experts to drown out fake health news on Instagram and Twitter

Christine Farr
CNBC.com
Originally published June 2, 2019

The antidote to fake health news? According to Austin Chiang, the first chief medical social media officer at a top hospital, it’s to drown out untrustworthy content with tweets, pics and posts from medical experts that the average American can relate to.

Chiang is a Harvard-trained gastroenterologist with a side passion for social media. On Instagram, where he refers to himself as a “GI Doctor,” he has 20,000 followers, making him one of the most influential docs aside from TV personalities, plastic surgeons and New York’s so-called “most eligible bachelor,” Dr. Mike.

Every few days, he’ll share a selfie or a photo of himself in scrubs along with captions about the latest research or insights from conferences he attends, or advice to patients trying to sort our real information from rumors. He’s also active on Twitter, Microsoft’s LinkedIn and Facebook (which owns Instagram).

But Chiang recognizes that his following pales in comparison to accounts like “Medical Medium,” where two million people tune in to the musings of a psychic, who raves about vegetables that will cure diseases ranging from depression to diabetes. (Gwyneth Paltrow’s Goop has written about the account’s creator glowingly.) Or on Pinterest and Facebook, where anti-vaccination content has been far more prominent than legitimate public health information. Meanwhile, on e-commerce sites like Amazon and eBay, vendors have hawked unproven and dangerous health “cures, ” including an industrial-strength bleach that is billed as eliminating autism in children.

The info is here.

The U.S. Healthcare Cost Crisis

Gallup
Report issued April 2019

Executive Summary

The high cost of healthcare in the United States is a significant source of apprehension and fear for millions of Americans, according to a new national survey by West Health and Gallup.

Relative to the quality of the care they receive, Americans overwhelmingly agree they pay too much, and receive too little, and few have confidence that elected officials can solve the problem.

Americans in large numbers are borrowing money, skipping treatments and cutting back on household expenses because of high costs, and a large percentage fear a major health event could bankrupt them. More than three-quarters of Americans are also concerned that high healthcare costs could cause significant and lasting damage to the U.S. economy.

Despite the financial burden and fears caused by high healthcare costs, partisan filters lead to divergent views of the healthcare system at large: By a wide margin, more Republicans than Democrats consider the quality of care in the U.S. to be the best or among the best in the world — all while the U.S. significantly outspends other advanced economies on healthcare with dismal outcomes on basic health indicators such as infant mortality and heart attack mortality.

Republicans and Democrats are about as likely to resort to drastic measures, from deferring care to cutting back on other expenses including groceries, clothing, and gas and electricity. And many do not see the situation improving. In fact, most believe costs will only increase. When given the choice between a freeze in healthcare costs for the next five years or a 10% increase in household
income, 61% of Americans report that their preference is a freeze in costs.

West Health and Gallup’s major study included interviews with members of Gallup’s National Panel of Households and healthcare industry experts as well as a nationally representative survey of more than 3,537 randomly selected adults.

The report can be downloaded here.