Moral injury and paramedic practice

Murray, Esther

doi:10.12968/jpar.2019.11.10.424

Cited by 23 publications

(24 citation statements)

References 9 publications

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“…Moreover, paramedics may also suffer from moral injury (perpetrating, failing to prevent or witnessing morally conflicting acts), manifesting as guilt, shame and emotional numbing. 3…”

Section: ‘Normal’ Job-related Stress and The Additional Psychologicalmentioning

confidence: 99%

“…Moreover, paramedics may also suffer from moral injury (perpetrating, failing to prevent or witnessing morally conflicting acts), manifesting as guilt, shame and emotional numbing. 3 During the ongoing COVID-19 pandemic, paramedics are at an even higher vulnerability to mental health problems. While paramedics realise their pivotal role in responding to emergencies and saving lives, they may also face major ethical and moral dilemmas, which can add to the psychological burden of care provision, especially in under-resourced settings.…”

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confidence: 99%

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Paramedics in pandemics: protecting the mental wellness of those behind enemy lines

2020

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“…Moreover, paramedics may also suffer from moral injury (perpetrating, failing to prevent or witnessing morally conflicting acts), manifesting as guilt, shame and emotional numbing. 3…”

Section: ‘Normal’ Job-related Stress and The Additional Psychologicalmentioning

confidence: 99%

mentioning

confidence: 99%

Paramedics in pandemics: protecting the mental wellness of those behind enemy lines

2020

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“…Moral distress and moral injury could be conceptualized as constructs along a continuum wherein moral distress is less severe (i.e., emotional responses to relatively common moral dilemmas) than moral injury (i.e., distress culminates in symptoms that are problematic, impairing, and potentially pathological; ( Farnsworth et al, 2017 ; Papazoglou and Chopko, 2017 ; Williamson et al, 2018 ). There are several theoretical publications examining moral injury in firefighter, paramedic, and police officer populations ( Miller, 2007 ; Bremer and Sandman, 2011 ; Papazoglou and Chopko, 2017 ; Murray, 2019 ), but empirical research clarifying the relationship between moral distress and moral injury, and how those constructs may impact the prevalence and treatment of PTSI is lacking.…”

Section: Introductionmentioning

confidence: 99%

Compromised Conscience: A Scoping Review of Moral Injury Among Firefighters, Paramedics, and Police Officers

et al. 2021

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BackgroundPublic Safety Personnel (e.g., firefighters, paramedics, and police officers) are routinely exposed to human suffering and need to make quick, morally challenging decisions. Such decisions can affect their psychological wellbeing. Participating in or observing an event or situation that conflicts with personal values can potentially lead to the development of moral injury. Common stressors associated with moral injury include betrayal, inability to prevent death or harm, and ethical dilemmas. Potentially psychologically traumatic event exposures and post-traumatic stress disorder can be comorbid with moral injury; however, moral injury extends beyond fear to include spiritual, cognitive, emotional or existential struggles, which can produce feelings of severe shame, guilt, and anger.ObjectiveThis scoping review was designed to identify the extant empirical research regarding the construct of moral injury, its associated constructs, and how it relates to moral distress in firefighters, paramedics, and police officers.MethodsA systematic literature search of peer-reviewed research was conducted using databases MEDLINE, EMBASE, APA PsychInfo, CINHAL PLUS, Web of Science, SCOPUS, and Google Scholar. Included studies were selected based on the inclusion criteria before being manually extracted and independently screened by two reviewers.ResultsThe initial database search returned 777 articles, 506 of which remained after removal of duplicates. Following review of titles, abstracts, and full texts, 32 studies were included in the current review. Participants in the articles were primarily police officers, with fewer articles focusing on paramedics and firefighters. There were two studies that included mixed populations (i.e., one study with police officers, firefighters, and other emergency service workers; one study with paramedic and firefighter incident commanders). Most studies were qualitative and focused on four topics: values, ethical decision-making, organizational betrayal, and spirituality.ConclusionPublic safety organizations appear to recognize the experience of moral distress or moral injury among public safety personnel that results from disconnects between personal core values, formal and informal organizational values, vocational duties, and expectations. Further research is needed to better understand moral distress or moral injury specific to public safety personnel and inform training and treatment in support of public safety personnel mental health.

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“…Concerns have been raised that. students who volunteer or graduated early 9 (interim foundation year 1 (FiY1) doctors) to take on front-line roles may not have su cient training on infection prevention and control, or su cient access to adequate personal protective equipment (PPE) 10 increasing the risk of emotional and/or moral injury 11 . The nature of their roles mean that they may be more exposed to the disease leading to increased concern for their own health and the risk they may pose to others 12 .…”

Section: Introductionmentioning

confidence: 99%

Medical students’ mood adversely affected by COVID-19 pandemic: An interim analysis from the SPICE-19 prospective cohort study of 2075 medical students and interim foundation doctors

Bandyopadhyay

Georgiou

Baykeens

et al. 2020

Preprint

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Abstract Background:Currently, we can only speculate on what the effects of the COVID-19 pandemic have been on medical students and interim foundation year doctors. In order to support them appropriately both now and, in the future, it is imperative that we understand the impact it has had upon them. This study assessed the effects of the COVID-19 pandemic on medical students and interim foundation year doctors across the United Kingdom (UK), and the support that they received and sought. Methods:A prospective, observational, multicentre study was conducted. All medical students and interim foundation year doctors were eligible to participate. The data analysis was carried out as detailed a priori in the protocol. Findings:A total of 2075 individuals participated in the SPICE-19 survey from 33 medical schools. There was a significant (p < 0.0001) decrease in participants’ mood when comparing their mood before the pandemic to during the pandemic. Social distancing and more time at home/with family were the factors that negatively and positively respectively impacted the mood of the greatest number of participants. All areas of life included in the survey were found to have been significantly more negatively impacted than positively impacted (p < 0.0001). 931 participants wanted more support from their university. Participants were mainly seeking support with exam preparation, course material, and financial guidance. Discussion:Medical and foundation schools need to prepare adequate and effective support. If no action is taken, there may be a knock-on effect on workforce planning and the health of our future workforce. When medical students return to their universities, there is likely to be need for enhanced wellbeing support, adaptations in the short-term and long-term strategies for medical education, and provision of financial guidance.

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Moral injury and paramedic practice

Cited by 23 publications

References 9 publications

Paramedics in pandemics: protecting the mental wellness of those behind enemy lines

Paramedics in pandemics: protecting the mental wellness of those behind enemy lines

Compromised Conscience: A Scoping Review of Moral Injury Among Firefighters, Paramedics, and Police Officers

Medical students’ mood adversely affected by COVID-19 pandemic: An interim analysis from the SPICE-19 prospective cohort study of 2075 medical students and interim foundation doctors

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