Moral Injury and Its Effect on Frontline Healthcare Workers: Understanding the Psychological Implications of the COVID-19 Pandemic
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The potential for moral injury in healthcare workers is increasingly salient on account of the COVID-19 pandemic. Healthcare workers on the frontlines have faced unprecedented human suffering, extraordinary working conditions, critical resource shortages, and excruciating decisions—with patients' lives hanging in the balance. The COVID-19 pandemic, an incredibly weighty chapter in modern history, has left some healthcare workers questioning themselves and the world around them; their values, beliefs, trust in others, and sense of morality and fairness, deeply compromised. This literature review discusses the rising incidence of moral injury in healthcare workers and the potential implications to heighten awareness and propose means of advocacy and support. A comprehensive examination of moral injury is married with recent empirical findings and practice recommendations. To be effective, field practitioners require foundational knowledge, cultural insight, and awareness of the potentially disproportionate impact of moral injury across healthcare populations. Further, an integrative service delivery model is discussed and proposed. A fulsome understanding of moral injury is becoming increasingly essential as healthcare workers look to mental health professionals for support and competency in this realm. Ongoing and future research is also very much needed. The current deficit of randomized controlled studies and direct research involving healthcare workers limits our current understanding of moral injury, including risk and protective factors and the efficacy of proposed treatment modalities. Now more than ever, the field of psychology needs to partner with and find innovative ways to address moral injury in healthcare populations for those who have offered so much of themselves throughout the COVID-19 crisis.