Moral Injury in Healthcare Workers: What Is It? Why Does It Develop? How to Prevent It?

Abstract

In extraordinary situations, healthcare workers may find themselves in positions of decision-making and practicing in the face of professionally and personally challenging ethical dilemmas which may result in moral injury. Moral injury is a spesific form of affect that is strong enough to shake one’s fundamental ethical values, attitudes, and explanations. It is seen in those who witness severe emotional damage, intense human suffering, and cruelty. This study aims to discuss the phenomenon of moral injury in healthcare workers, the factors that contribute to its development, and the strategies for prevention in the context of preparation for extraordinary situations. Moral injury erodes a person’s perception of being an active and independent subject, his/her value integrity, and basic sense of well-being, and negatively affects him/her psychologically, socially and spiritually. Healthcare workers who are exposed to moral injury may become alienated from themselves and their profession, and may have to cope with feelings of burnout and hopelessness. This may lead to depression, anger, feelings of inadequacy, and disengagement from the profession in healthcare workers. By raising general awareness, empowering those at risk, and implementing collective cultural transformation efforts, it is possible to compensate for the negative effects of moral injury by helping people become morally resilient. These initiatives must be planned holistically as part of preparation for and building resilience to adverse events. They should be integrated with work processes at the organizational, system, and community levels, as well as at interpersonal (healthcare worker – patient) level. The competence and moral resilience of the health workforce should be regarded as an essential element of emergency preparedness. Conversely, being inadequately prepared for extraordinary situations may result in moral injury among healthcare workers. We posit that further empirical studies on the morally challenging experiences of healthcare workers in our country, where extraordinary situations are frequently encountered, will facilitate the comprehension of this significant phenomenon and the advancement of initiatives to enhance moral resilience. © 2025, Turkish Medical Association. All rights reserved.