Comparison of potential moral harm among veterans and health care workers
Newswise – A study comparing 618 military veterans deployed to a combat zone after 9/11 and 2,099 healthcare workers (HCWs) working during the COVID-19 pandemic found similar levels of potential moral harm (PMI), with 46.1% of veterans and 50.7% of healthcare workers reporting PMI.
PMI – the strong cognitive and emotional response that can occur following events that violate a person’s moral or ethical code – was assessed in two categories: induced by others and self-induced. Military veterans’ IMP was significantly associated with gender, race, enlisted versus officer status, and post-battle traumatic experiences among veterans; Healthcare worker PMI was associated with age, race, working in a high-risk COVID-19 setting, and reported COVID-19 exposure among healthcare workers.
PMI was associated with significantly higher depressive symptoms and poorer quality of life in both samples and higher rates of burnout among healthcare workers.
“The examples of PMI we saw the most were individuals who were supposed to do things that made them doubtful about their participation,” said Keith Meador, MD, ThM, MPH, professor of psychiatry and health policy, director of the Vanderbilt Center for Biomedical Ethics and Society, and author on Journal of General Internal Medicine report.
“In the context of health care, this may not seem to be able to provide the level of care that one would like to provide due to the complexity of the ongoing pandemic. As a result, healthcare workers were vulnerable to the consequences of potential hurt feelings and reduced mental health quality, similar to what we saw in veterans after 9/11.
Meador worked with colleagues to identify areas for potential improvement in the mental health of healthcare workers. One area that shows promising results is collaboration between chaplains and mental health care providers. Much of Meador’s work has focused on equipping chaplains to be knowledgeable and aware of PMI in healthcare and military settings.
On the front lines of hospitals and wars, people often begin to question their self-esteem. Whether someone identifies as religious or not, they often seek out chaplains to answer questions about the intersection between their professional identity and their purpose.
In collaboration with Jason Nieuwsma, PhD, assistant associate professor in the practice of integrative chaplaincy at Vanderbilt Divinity School and associate professor in the department of psychiatry and behavioral sciences at Duke University Medical Center, first author of the article, Meador has established a Doctor of Ministry program. at Vanderbilt which equips chaplains in evidence-based practices to be care providers for people with PMI.
“These results are a real message about the stress of the past two years for our healthcare workers and our need for vigilance around these issues to better support them,” Meador said. “We are working to transform moral suffering and cultivate even more resilience. We need to use all sorts of preventive and primary interventions to support healthcare workers.
Topics surrounding the mental distress and resilience of healthcare workers will be discussed at the inaugural Kate Payne Lecture on April 13 at noon at 208 Light Hall. To join via Zoom, click here.