Moral Injury:
Piercing the Spirit
Moral injury increasingly impacts professionals in high intensity careers. Healthcare, social service, humanitarian aid, and law enforcement/legal professionals are at especially high risk.
Moral injury happens when systems are in place that make it impossible to prevent human suffering. It’s further intensified when you feel like you have become a part of the system itself that is perpetrating the harm or withholding safety.
Consider the physician or nurse unable to provide the care needed by their patient because of an over-burdened healthcare system, the “allowable” 10 minutes of care is insufficient, or the treatment is declined by insurance. Or, a child welfare worker constrained by a legal system that requires them to return a vulnerable child into a living situation that is fundamentally unsafe and inadequate. On the global front a humanitarian aid worker unable to deliver desperately needed aid is left to witness mass starvation and death of malnourished children. A law enforcement officer or prosecutor is unable to secure justice for a victim, because of a legal technicality.
Each one of these professionals entered their chosen field with a commitment to do good, to heal, to serve, and to protect the vulnerable. Each one inevitably finds themselves within the bureaucracy of broken systems that prevent them from preventing or alleviating the suffering of others. Sadly these are rarely one-time occurrences, and the impact of moral injury is cumulative.
Moral injury is a wound that goes beyond burnout and exhaustion, it is beyond psychological trauma. Moral injury pierces the spirit, touching us at an existential level.
In addition to depression, anxiety, PTSD, and a broad range of health impacts, moral injuries can result in shame, rage, hopelessness, and a depth of despair that can lead to suicidality. Not surprisingly many gifted professionals choose to leave their respective fields.
So what must be the response?
First, we have to name it and understand moral injury for what it is.
Next, we need to change the systems and infrastructure that perpetuate these situations.
Finally, we need to provide real resources to support healing for those who have experienced moral injury. This involves comprehensive interdisciplinary support that goes beyond performative workplace wellbeing initiatives.
If you are suffering from moral injury, reach out for help. Seek out a community of support with those who understand. While it’s not possible to out-run these kinds of injuries, healing and renewal are possible when you surround yourself with the support you need.