Throughout the pandemic, people have had to make impossibly tough decisions. Kathleen Turner, a 52-year-old intensive-care nurse in San Francisco, has been haunted by hers. Since COVID-19 patients started overwhelming her hospital last spring, she has had to give patients sedatives knowing they would likely have lasting negative health consequences, and systematically deny relatives a chance to say goodbye to dying loved ones. Last year, Turner was following guidelines when she told a woman that she could not visit her dying mother—on Mother’s Day. “I upheld the rule on the piece of paper,” she told me. “But in terms of what would a good person do? It’s not that.” Collectively, these experiences have fundamentally shaken her sense of morality. “Am I really a good person? There’s that seed of doubt,” she said.
Health-care workers have had it especially hard during the pandemic, triaging who gets access to life-saving medication and reusing personal-protective equipment with the risk of contaminating patients, colleagues, and themselves. But other people have also been forced into unenviable scenarios. Undertakers have had to empty out old graves to make space for more dead bodies. Many of us have wrestled with whether to visit a parent or grandparent given the possibility of exposing them to the virus. In some cases, these situations have left people with what psychologists call “moral injury”—residual feelings of shame, guilt, and disorientation after having violated their own ethical code. Often, moral injury manifests as feelings of betrayal at the leaders and institutions that forced them into making these decisions in the first place, which may lead to behaviors such as substance abuse and social isolation.