What causes the distress described as moral injury for healthcare professionals?
Knowing the ethically correct action but being prevented by systemic constraints
Moral injury is a specific form of distress that occurs when a healthcare professional recognizes the morally or ethically correct course of action required for optimal patient outcomes, but external forces prevent them from executing it. These preventing forces are typically organizational or systemic constraints, such as resource limitations or throughput demands that mandate faster patient turnover. For example, feeling compelled to discharge a patient who genuinely needs more recovery time violates the professional’s internal ethical standard. Unlike typical stress, moral injury stems from repeated systemic failures that undermine professional integrity, resulting in a deep psychological scar and a profound sense of failure, even when the provider is technically adhering to impossible operational rules.
