Moral Injury: A Systemic Issue in Medicine


From the Lown Institute: “When the majority of health professionals are experiencing feelings of exhaustion, disillusionment, detachment, and depression, could this possibly be a problem that individuals can solve? Absolutely not. […]

Clinicians have previously pointed out the systemic nature of exhaustion and depression among health care workers. In a Youtube video this week, Dr. Zubin Damania (aka ZDoggMD) argues that the term ‘burnout’ mischaracterizes the issue, and furthers the status quo (Warning: This video contains strong language).

‘Burnout is a kind of victim shaming,’ explains Damania. ‘It’s saying, you’re not resourceful enough, you’re not strong enough, to adapt to a system.’

Damania cites Dr. Simon Talbot and Dr. Wendy Dean’s usage of the term ‘moral injury’ to describe what happens when health care workers who are following a calling to help others confront a system that cares only about profit. Our health care system ‘is the opposite of what [clinicians’] morality tells them they need to do for patients,’ says Damania.”

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  1. This article is consistent with the work of Dr. Pamela Wible. When I complained to Dr. Wible about psychiatric abuse, she claimed that psychiatric abuse is a part of the cycle of abuse starting with the way medical students are treated. While I sympathize with doctors who have their hands tied and cannot adequately treat their patients in the current system, this article takes the issue to a new level by claiming that doctors who must work in a profit driven business model are ‘morally injured’. I am skeptical of portraying doctors as victims. Studies show that most doctors enter the field to enjoy the good life. Check. When my dad was the Dean of Students at Portland State University in the seventies, he risked everything to supported his student’s first amendment right to protest the Vietnam War for which he was later blacklisted/dismissed. Our family experienced poverty after that but I have only admiration for my dad’s moral stand. My uncle, a physician, volunteered on the weekend to treat patients for free at a clinic founded by the Black Panthers for which his phone was tapped, even though my uncle was a pacifist Quaker and didn’t have a violent bone in his body. I think that doctors suffer less from moral ‘injury’ and more from lack of moral backbone.

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    • Moral injury–unlike physical or emotional–can only be done with the consent of the injured. Lack of moral backbone–as Madmom says is the big problem leading to “moral injury.” Do what is right and you won’t damage your conscience.

      Btw, when I hear high ranking shrinks enjoying wealth, power, and fame whimpering how stigma really only effects them i laugh out loud. Like some Grand Wizard saying any opposition to the KKK is racist. And it’s all directed at him personally. Bwahahaha!

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