Potential Sources of Moral Injury for Healthcare Workers in Forensic and Psychiatric Settings: A Systematic Review and Meta-ethnography

The current research examines potentially morally injurious events (PMIEs) faced by healthcare professionals working in forensic and psychiatric environments. A systematic literature review was conducted to identify peer-reviewed articles reporting on sources of moral injury or similar concepts (e.g...

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Published inTrauma, Violence, & Abuse Vol. 25; no. 2; pp. 918 - 934
Main Authors Webb, Elanor Lucy, Ireland, Jane L., Lewis, Michael, Morris, Deborah
Format Book Review Journal Article
LanguageEnglish
Published Los Angeles, CA SAGE Publications 01.04.2024
Sage Publications Ltd
Subjects
Dichotomies
Discordance
Ethics
Ethnography
Forensic science
Health care
Health Personnel
Health services
Humans
Injuries
Injury prevention
Literature reviews
Medical personnel
Moral injury
Profession
Psychological distress
Review Manuscripts
Stress Disorders, Post-Traumatic - psychology
Systematic review
PMIEs
forensic mental health
forensic healthcare
meta-ethnographic
moral injury
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Summary:The current research examines potentially morally injurious events (PMIEs) faced by healthcare professionals working in forensic and psychiatric environments. A systematic literature review was conducted to identify peer-reviewed articles reporting on sources of moral injury or similar concepts (e.g., moral distress) for healthcare workers in such settings. Thirty articles were included and analyzed using a meta-ethnographic approach. Synthesis yielded three third-order factors, each reflecting a moral dichotomy: (a) “between profession and system,” (b) “between relations with patients and relations with others,” and (c) “between principles and practices.” Findings illustrated the hierarchical relationships between dichotomies, with discordance between values of the healthcare profession and features of the healthcare system providing the conditions for PMIEs to occur. The review advances conceptual understandings of PMIEs in forensic and psychiatric settings, illustrating the multilayered dimensions within which morally injurious events are experienced. Theoretical and practical implications are offered that may support the early detection and prevention of moral injury in healthcare professionals.
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ISSN:1524-8380
1552-8324
DOI:10.1177/15248380231167390