Moral injury and burnout in medicine, a year of lessons learned: STAT

“When we began exploring the concept of moral injury to explain the deep distress that U.S. health care professionals feel today, it was something of a thought experiment aimed at erasing the preconceived notions of what was driving the disillusionment of so many of our colleagues in a field they had worked so hard to join,” Wendy Dean and Simon G. Talbot write for STAT. “As physicians, we suspected that the ‘burnout’ of individual clinicians, though real and epidemic, was actually a symptom of some deeper structural dysfunction in the health care system. The concept of ‘moral injury’ seemed to encapsulate the organizing principle behind myriad drivers of distress: the growing number of reasons we couldn’t keep the oath we had made to always put our patients first. Moral injury describes the mental, emotional, and spiritual distress people feel after ‘perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations.’ It was originally described by VA clinicians to account for the way that the suffering of some military veterans did not respond to standard treatment for post-traumatic stress disorder. This way of conceptualizing soldiers’ suffering felt deeply familiar to us, and we thought it might provide a compelling account of the cause of the burnout we have witnessed in our colleagues and ourselves. Posing a new question in the conversation around physician burnout, we published a First Opinion on moral injury on this date last year. We were stunned by the response. That article started an international conversation among health care professionals and others about the moral foundations of medicine and has begun to change the language around clinician distress.” Wendy Dean and Simon G. Talbot, “Moral injury and burnout in medicine: a year of lessons learned,” STAT.