Moral injury similar between combat veterans and COVID-19 HCWs

Editor's Note

This collaborative study by researchers at Duke University, Vanderbilt University, and the Department of Veterans Affairs, finds that COVID-19 healthcare workers (HCWs) experienced high rates of moral injury, comparable to rates among military veterans. Moral injuries are described as actions that conflict with values and beliefs, causing psychological harm.

The researchers analyzed data from 618 post-9/11 combat veterans and 2,099 COVID-19 HCWs.

Among the findings:

• 46% of veterans and 51% of HCWs were troubled by other’s immoral behavior
• 24% of veterans and 18% of HCWs were troubled by violating their own morals and values
• both veterans and HCWs who experienced incidents of moral injury had more depression and lower quality of life, and HCWs had higher levels of burnout.

HCW experiences that conflicted with their moral values included the public’s disregard for preventing COVID-19 transmission, seeing patients die, enduring staffing shortages, rationing care and PPE, and disallowing visitors to see dying patients.

Though burnout is real and often discussed by HCWs, moral injury may be a more accurate description of their experience and may have implications for the future, the researchers note.