What happens when the healers become the wounded? When doctors and nurses are forced to make choices that violate their deepest ethical vows? In this compelling episode of The Science Chick Report, Dr. Kathleen Kendall-Tackett explores the concept of moral injury, a term once reserved for military contexts but now emerging as a crucial framework for understanding the psychological and ethical toll of the COVID-19 pandemic on healthcare providers.
Drawing from 46 empirical studies, Dr. Kendall-Tackett breaks down how physicians, nurses, and frontline workers faced impossible ethical choices, from resource shortages to patient isolation policies. She explains how these experiences overlapped with post-traumatic stress disorder (PTSD) yet carried a distinct moral and spiritual dimension.
Through striking quotes from clinicians and international studies, she unpacks seven defining themes of moral injury: ethics, high-stakes decisions, moral transgressions, betrayal, psychological wounds, spiritual wounds, and reconciliation, revealing the deep emotional cost of caregiving in crisis. The episode also highlights promising therapeutic pathways for recovery, including Acceptance and Commitment Therapy and Trauma-Informed Guilt Reduction Therapy.
If you care about the mental and moral well-being of those who care for others, this episode is essential listening.
In This Episode:
(00:00) Introduction and research update
(00:59) Definition and context of moral injury
(02:17) COVID-19’s impact on healthcare providers
(03:12) Differentiating moral injury from PTSD
(04:16) PTSD criterion A and trauma exposure
(06:16) Healthcare providers’ fears and experiences
(07:30) Key elements of moral injury
(09:35) Ethics and moral transgressions
(11:49) High-stress environments
(12:50) Orientation: immoral acts and guilt
(13:51) Betrayal by authorities
(15:51) Psycho-behavioral wounds
(17:01) Spiritual and existential wounds
(18:05) Burnout and functional impairment
(20:06) Suicide risk and hopelessness
(21:05) Reconciliation and resilience
(23:27) Summary and research implications
(24:28) Closing remarks
Notable Quotes:
(02:06) "The COVID-19 pandemic was a different kind of crisis because it put an enormous, unprecedented strain on all healthcare systems worldwide." – Dr. Kathleen Kendall-Tackett
(07:08) "As with soldiers in war, we know that as soon as we stop doing, we will start feeling the deterred processing of grief and trauma and betrayal for the patients we've lost." – Dr. Kathleen Kendall-Tackett
(13:37) "I almost wanted to tell people if they knew what had gone on and if they knew how bad things were, you wouldn't be clapping, you'd be writing petitions and storming Parliament." – Dr. Kathleen Kendall-Tackett
(14:59) "If I die, they don't care. They'll just get someone else in my shoes tomorrow." – Dr. Kathleen Kendall-Tackett
(17:01) "I didn't feel like I was a doctor. I felt like I was just letting people die." – Dr. Kathleen Kendall-Tackett
(19:56) "The last 20 months have been the most stressful, exhausting, and depressing time in my 30-year medical career." – Dr. Kathleen Kendall-Tackett
Resource & Links
Podcast
The Science Chick Report
Dr. Kathleen Kendall-Tackett
Mentioned
Journal Traumatology – Upcoming article on Moral Injury in Healthcare
National Center for PTSD – Moral Injury Treatment Guidelines
Acceptance and Commitment Therapy (ACT) for Moral Injury
Trauma-Informed Guilt Reduction Therapy
Western Sydney University Moral Injury Studies