Moral dilemmas and traumatic stress during COVID-19

The COVID-19 pandemic places many people at risk for exposure to potentially traumatic events. Some of us have already faced the loss of a loved one, long-term isolation from family and friends, or perhaps a near-death experience ourselves. But this pandemic brings another type of trauma-related risk: the risk of sustaining a moral injury.

What is moral injury?

A moral injury may occur when a person witnesses, fails to prevent, or engages in an event that violates their personal moral beliefs. Exposure to morally injurious situations has been linked to post-traumatic stress disorder and can bring profound shame, anguish, and guilt that severely disrupts one’s quality of life.

In the context of COVID-19, a moral injury could occur after an individual faces an ethical dilemma that results in harm to another or to oneself. For example:

  • A doctor who must make difficult decisions about how to deploy limited life-saving resources, such as ventilators
  • A healthcare worker who may put their own children at risk by continuing to work
  • An individual who cannot be with a terminally ill loved one due to self-illness or facility restrictions
  • An undiagnosed person who inadvertently infects vulnerable residents in a nursing home

These are wrenching situations no one wants to face.  And they can leave us scarred.


What to do if you experience traumatic events

“The first thing to do if you are exposed to a traumatic event is to talk about it,” says Dr. Margaret McKinnon, an HRI-supported scientist and trauma expert from McMaster University.

Dr. McKinnon serves as Homewood Research Chair in Mental Health and Trauma and is leading important research related to moral injury.

“Talk to your colleagues or close personal network. Failing to acknowledge a morally injurious event can make matters worse, so share your experiences and support one another. The next thing to do is to practice self-compassion and self-care as you move through these challenging times. Many virtual tools are now available to support our resilience and mental health.”

And finally, if you experience persistent and overwhelming feelings related to a traumatic experience that are severely disrupting your quality of life, talk to a mental health professional.

“Help is available, and protecting our mental wellbeing is of the utmost importance,” says McKinnon.


Mental health resources during COVID-19

If you are an Ontario healthcare worker, you can access free phone therapy sessions provided by licensed mental health workers who are volunteering their services during the COVID-19 pandemic.

For anyone experiencing mental health concerns, many online resources are available, including:


How to practice self-compassion and self-care

  • Accept your feelings without judgement. It is normal to feel negative emotions during uncertain times or after experiencing a traumatic event. Name your feelings and be gentle with yourself as you sit with them and process them.
  • Do your best to maintain healthy lifestyle habits. If you are able, maintain a regular sleep, exercise and meal schedule. Take breaks, communicate with your peers and family, and use mental health tools that work for you. A list of resources is available below.
  • Practice mindfulness techniques. A variety of mindfulness tools exist online. Apps such as Calm and Insight Timer provide guided recordings, breathing exercises, and other tools to stay grounded in the here and now.
  • Continue doing all you can. Follow public health recommendations to slow the spread of COVID-19. Stay informed via reputable news sources (but don’t be afraid to take a media break if you need one.) Remind yourself of the positive outcomes you contribute to each day.

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