[Moral injury in medicine: recognition and guidance]

Moral injury signifies a permanent mental wound characterized by feelings of guilt, shame, anger or moral disorientation. Physicians may become morally injured whenever they act in a way that conflicts with deeply held, moral beliefs. During a pandemic, a war or whenever physicians provide care to large numbers of refugees, there is a heightened risk of moral injury. These circumstances cause conditions of scarcity of personnel and resources, and urge governments and societies to sometimes ask physicians to act in manners which conflict with their moral beliefs. Moral injury can have damning consequences for the professionals involved. That is why it is essential that physicians learn to recognize the signs of moral injury within themselves and with colleagues.