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"Ruptured selves: moral injury and wounded identity"
Jonathan M Cahill1, Ashley J Moyse1, Lydia S Dugdale2
1Center for Clinical Medical Ethics, Department of Medicine, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA.
Medicine, Health Care, and Philosophy
|February 13, 2023
Summary
Moral injury, trauma from violating core values, damages one's moral identity. Healing requires community involvement to repair this relational sense of self, especially for healthcare professionals.
Area of Science:
- Philosophy
- Psychology
- Ethics
Background:
- Moral injury arises from profound violations of deeply held values and beliefs.
- Healthcare professionals are particularly vulnerable to moral injury due to their work environments.
- Understanding the link between moral injury and moral identity is crucial for effective interventions.
Purpose of the Study:
- To explore the connection between moral injury and moral identity using relational philosophical anthropologies.
- To examine the implications of this connection for moral repair, especially within the healthcare sector.
- To define moral identity as a relational and narrative construct essential for moral action.
Main Methods:
- Drawing on relational philosophical anthropologies.
- Analyzing the concept of moral identity as a relational and narrative constitution of the self.
- Investigating the impact of moral injury on the formation and integrity of moral identity.
Main Results:
- Moral injury ruptures the sense of self, leading to moral disorientation and damaged moral identities.
- Moral identity is relationally formed within communities and through narrative.
- Moral repair is fundamentally a communal and relational process, not solely an individual one.
Conclusions:
- Moral repair necessitates the involvement of others to heal a damaged moral identity.
- Healing moral injury involves transforming one's moral identity within a supportive community.
- Relational approaches are key to addressing moral injury and fostering moral repair in healthcare professionals.
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