News: Healthcare professionals experiencing moral injury similar to combat veterans, study finds

During the COVID-19 pandemic, healthcare workers have experienced moral injury at levels comparable to combat veterans, according to new research published in the Journal of General Internal Medicine. The research is based on information gathered from 618 veterans who served in a combat zone after September 11, 2001, and 2,099 healthcare workers who have provided care during the pandemic.

Moral injury has been defined as the “psychological, biological, spiritual, behavioral and social impact of perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations.” The new research examined two kinds of potential moral injury:

• Other-induced potential moral injury, which involves being disturbed by the immoral acts of others
• Self-induced potential moral injury, which involves being disturbed by violating your own morals

According to HealthLeaders, the study revealed several key data points:

• 46.1% of combat veterans and 50.7% of healthcare workers reported other-induced potential moral injury
• 24.1% of combat veterans and 18.2% of healthcare workers reported self-induced potential moral injury
• For healthcare workers, other-induced potential moral injury was linked to younger age and COVID-19 exposure
• For healthcare workers, self-induced potential moral injury was linked to younger age, nonwhite race, working in a high-risk setting, and COVID-19 exposure
• Healthcare workers who reported other-induced potential moral injury had higher levels of depression and lower quality of life compared to healthcare workers who did not report other-induced potential moral injury
• Healthcare workers who reported self-induced potential moral injury had higher levels of depression and lower quality of life compared to healthcare workers who did not report self-induced potential moral injury
• Healthcare workers who reported other-induced or self-induced potential moral injury experienced significantly higher levels of burnout compared to healthcare workers who did not report other-induced or self-induced potential moral injury

Of course, it’s not the first study to show increasing levels of burnout and moral injury connected to the pandemic. A 2022 study from KLAS found that pre-pandemic, 25% of clinicians reported some degree of burnout. Now, the number has risen to 33%. Additionally, a 2021 study from the Jackson Physicians Search that found that 36% of surveyed physicians planned to either take an early retirement or leave the medical profession entirely. In short, the pandemic has put tremendous pressure on healthcare workers, and its effects will likely have a lasting impact on healthcare well into the future.

Editor’s note: To read HealthLeaders’ coverage of this story, click here. To read the full research report from the Journal of General Internal Medicine, click here. To read the latest research about the pandemic and physician burnout from KLAS, click here.