Moral injury and paramedic practice

I first learned about moral injury by accident. I was looking for work on the effects of vicarious trauma on health professionals and stumbled across Jonathan Shay's (2012) article on moral injury in military personnel, including military medics. I was surprised to find a real dearth of research on the psychological effects of treating patients of any kind, of breaking bad news or witnessing horrific injuries or interpersonal violence. I had imagined there must be an understanding of how health professionals were affected by their work but I found that, for the most part, the literature focused on compassion fatigue and burnout.

The term ‘moral injury’ has been used to describe the psychological effects of ‘bearing witness to the aftermath of violence and human carnage’ (Litz et al, 2009: 700) and encompasses witnessing human suffering, or failing to prevent outcomes which transgress deeply-held beliefs, such as the rights of a child to be protected by their parents, or the belief that life can and should be preserved by appropriate and timely medical intervention.