First, do no harm. The main tenet of the Hippocratic Oath doctors take when beginning their career to care for patients. But what happens when they have to navigate roadblocks that prevent them from putting patients first? Issues of insurance, electronic medical record-keeping, litigation, and budgets mean many doctors face as much time filling out forms as they do at the bedside.
According to Dr Wendy Dean, “every time medical professionals have to choose anything other than their patient, it can be indicative of moral injury, or it predisposes them to moral injury.” Dr Dean and Dr Simon Talbot first used this term in a 2018 opinion piece that resonated with many.
The term ‘moral injury’ has its roots in war. It was first used to explain why military veterans were not responding to standard treatment for post-traumatic stress disorder. Moral injury, as defined by researchers from veterans’ hospitals, refers to the emotional, physical and spiritual harm people feel after “perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations.” Talbot and Dean concluded that moral injury describes the conundrum of today’s medical professionals: They know how best to care for their patients but are blocked from doing so by systemic barriers related to the business side of healthcare.
On the next episode we’ll examine this concept of moral injury in the medical field, and the toll it may be having